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Related Experiment Videos

Clopidogrel-induced systemic inflammatory response syndrome.

Ido Wolf1, Meir Mouallem, Shmuel Rath

  • 1Department of Medicine E, Institute of Oncology, The Sheba Medical Center, Tel-Hashomer, Israel. ido.wolf@sheba.health.gov.il

Mayo Clinic Proceedings
|May 15, 2003
PubMed
Summary

Clopidogrel bisulfate, an antiplatelet medication, can cause a severe inflammatory reaction. This syndrome, characterized by fever and rash, necessitates prompt drug withdrawal for patient safety.

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Area of Science:

  • Cardiology
  • Pharmacology
  • Immunology

Background:

  • Clopidogrel bisulfate is a P2Y12 inhibitor commonly used to prevent platelet aggregation.
  • It is generally considered safe, comparable to aspirin, for cardiovascular indications.
  • Patient safety and adverse drug reactions are critical considerations in clinical practice.

Observation:

  • A patient presented with systemic inflammatory response syndrome (SIRS) following clopidogrel administration.
  • Symptoms included high fever, tachycardia, a rash resembling cellulitis, impaired liver function, and mild leukopenia.
  • These symptoms emerged after clopidogrel use prior to coronary angiography and stent implantation.

Findings:

  • The patient's reaction resolved upon discontinuation of clopidogrel bisulfate.

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  • A recurrence of symptoms was observed shortly after a drug rechallenge.
  • The clinical presentation and response to withdrawal/rechallenge strongly indicated a clopidogrel-induced adverse reaction.

    • Implications:

    • This case highlights a rare but serious adverse effect of clopidogrel bisulfate.
    • Prompt recognition and discontinuation of clopidogrel are crucial for managing this syndrome.
    • Avoiding unnecessary treatments and invasive procedures depends on accurate diagnosis of drug-induced reactions.