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Clopidogrel-associated acute migratory arthritis following kidney-pancreas transplantation

A S R Muthusamy1, A Vaidya, P J Friend

  • 1Oxford Transplant Centre, Churchill Hospital, Headington, Oxford, United Kingdom. anandsivaprakash@hotmail.com

International Journal of Immunopathology and Pharmacology
|July 13, 2006
PubMed

Insights

Clopidogrel use in a kidney-pancreas transplant patient led to joint pain and inflammation. Symptoms resolved after discontinuing the antiplatelet medication, highlighting potential adverse effects in transplant recipients.

Area of Science:

  • Nephrology
  • Transplantation immunology
  • Pharmacology

Background:

  • Clopidogrel is an antiplatelet medication crucial for preventing thrombosis post-transplant.
  • Simultaneous kidney-pancreas transplantation is a complex procedure requiring careful management of immunosuppression and anticoagulation.
  • Alternative antiplatelet agents are sought for patients with contraindications, such as aspirin allergy.

Observation:

  • A 34-year-old male with type 1 diabetes and uremia received a simultaneous kidney-pancreas transplant.
  • The patient was administered clopidogrel due to an allergy to aspirin.
  • Polyarthralgia (joint pain) emerged one week post-transplantation, followed by symmetrical migratory polyarthritis.

Findings:

  • The patient experienced significant joint pain and inflammatory arthritis attributed to clopidogrel.
  • Discontinuation of clopidogrel resulted in complete resolution of the polyarthritis.
  • This suggests a potential adverse drug reaction to clopidogrel in this specific patient population.

Implications:

  • Clinicians should consider the risk of drug-induced arthritis when prescribing clopidogrel to transplant recipients.
  • Careful monitoring for musculoskeletal adverse events is warranted in patients on clopidogrel post-transplantation.
  • This case highlights the importance of individualized medication selection in complex transplant scenarios.

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