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Related Experiment Videos

Ticlopidine-induced lupus.

Y Braun-Moscovici1, D Schapira, A Balbir-Gurman

  • 1Department of Rheumatology, Rambam Medical Center, The Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.

Journal of Clinical Rheumatology : Practical Reports on Rheumatic & Musculoskeletal Diseases
|October 14, 2006
PubMed
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Ticlopidine, used to prevent vascular events, may trigger drug-induced lupus. Symptoms like fever, rash, and arthritis resolved after discontinuing the medication, suggesting a causal link.

Area of Science:

  • Rheumatology
  • Pharmacology
  • Internal Medicine

Background:

  • Ticlopidine is a thienopyridine antiplatelet agent prescribed for stroke and vascular event prevention.
  • Drug-induced lupus erythematosus (DILE) is a recognized adverse effect of various medications.
  • Identifying drug triggers for lupus is crucial for patient management and understanding pathogenesis.

Purpose of the Study:

  • To report three cases of lupus-like illness potentially induced by ticlopidine.
  • To highlight the clinical features and diagnostic considerations for ticlopidine-induced lupus.
  • To emphasize the importance of drug withdrawal for symptom resolution.

Main Methods:

  • Case series describing three patients who developed lupus-like symptoms after ticlopidine initiation.

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  • Clinical evaluation including physical examination, laboratory tests (antinuclear antibodies, antihistone antibodies), and assessment of symptom progression.
  • Monitoring of patient response to ticlopidine discontinuation.

    • Main Results:

    • All three patients presented with fever, rash, arthritis, and laboratory evidence of autoimmunity (positive antinuclear and antihistone antibodies).
    • Symptoms appeared shortly after starting ticlopidine and gradually resolved upon drug cessation.
    • Renal involvement was noted in one patient, which also improved after ticlopidine withdrawal.

    Conclusions:

    • Ticlopidine can be a potential trigger for drug-induced lupus, presenting with characteristic lupus-like features.
    • Clinical suspicion supported by laboratory findings (fever of unknown origin, musculoskeletal, hematologic abnormalities) is key for diagnosis.
    • Discontinuation of ticlopidine leads to slow but complete resolution of symptoms in most cases.