A Rare Case of Clopidogrel-Induced Migratory Polyarthritis in a Patient With Recent Myocardial Infarction

Area of Science:

• Cardiology
• Pharmacology
• Rheumatology

Background:

• Clopidogrel is a P2Y12 inhibitor widely used for secondary prevention of cardiovascular events, including myocardial infarction.
• Dual antiplatelet therapy (DAPT) with aspirin and clopidogrel is standard post-acute myocardial infarction, particularly after stent placement.
• While common side effects include bleeding and rash, rare adverse effects like arthritis require clinical attention.

Observation:

• A 53-year-old male patient developed severe, debilitating polyarthritis affecting knees and shoulders within three weeks of initiating aspirin and clopidogrel therapy.
• The patient's mobility was significantly impaired due to the acute onset of joint pain.
• No other potential causes for the arthritis were immediately apparent.

Findings:

• Discontinuation of clopidogrel resulted in a rapid and dramatic improvement in the patient's joint pain and mobility.
• Complete resolution of arthritic symptoms was observed within one week of stopping clopidogrel.
• This case suggests a potential causal link between clopidogrel use and the development of drug-induced arthritis.

Implications:

• Clinicians should consider drug-induced arthritis as a rare adverse effect in patients presenting with new-onset polyarthritis while on clopidogrel.
• Prompt recognition and discontinuation of the offending agent may lead to swift symptom resolution.
• Further investigation into the mechanisms of clopidogrel-induced arthropathy may be warranted.