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Clopidogrel-induced refractory thrombotic thrombocytopenic purpura successfully treated with rituximab

Sara Khodor1, Miguel Castro2, Colin McNamara1

  • 1Charles E. Schmidt College of Medicine, Boca Raton, FL, USA.

Hematology/Oncology and Stem Cell Therapy
|December 20, 2015
PubMed

Thrombotic thrombocytopenic purpura (TTP) is a multisystem disorder characterized by microvascular aggregation of platelets and fibrin strands causing thrombocytopenia, microangiopathic hemolytic anemia, and organ dysfunction. TTP can develop as a result of a deficiency in ADAMTS13 enzyme activity due to either a genetic defect or, more commonly, the development of anti-ADAMTS13 autoantibodies. TTP can also be associated with pregnancy, organ transplant, lupus, infections, and drugs. Here, we present a case of TTP that developed shortly after the start of clopidogrel treatment for acute ischemic stroke and acute myocardial infarction, and describe the clinical presentation, refractory course of the disease, and successful induction of remission through the use of rituximab in a setting of pre-existing autoimmune diseases.

Keywords:
ADAMTS13ClopidogrelHemolytic uremic syndromeRituximabThrombotic thrombocytopenic purpura

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