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The Mystery of Clopidogrel-Associated Inflammatory Arthritis

Faiza Javed1, Shivam U Champaneria2

  • 1Hospital Medicine, University of Kentucky College of Medicine, Lexington, USA.

Cureus
|December 18, 2023
PubMed

Insights

Clopidogrel, an antiplatelet drug, can cause inflammatory arthritis in patients. Stopping the medication resolved the patient's symptoms, highlighting the importance of considering drug-induced causes.

Area of Science:

  • Cardiology
  • Rheumatology
  • Pharmacology

Background:

  • Clopidogrel is a crucial antiplatelet agent for preventing thrombotic events in acute coronary syndrome and ischemic stroke.
  • Dual antiplatelet therapy (DAPT) is standard for stroke patients, but potential side effects require careful consideration.

Observation:

  • A male patient developed inflammatory arthritis five days after initiating maintenance clopidogrel for stroke treatment.
  • Extensive workup for common and autoimmune causes of inflammatory arthritis yielded negative results.

Findings:

  • The patient's inflammatory arthritis was hypothesized to be induced by clopidogrel.
  • Discontinuation of clopidogrel led to complete resolution of arthritis symptoms.

Implications:

  • Drug-induced arthritis should be considered in patients presenting with inflammatory arthritis, especially those on new medications like clopidogrel.
  • A thorough differential diagnosis is essential, as medication-induced arthritis is a diagnosis of exclusion.
  • Risk-benefit assessment of DAPT in ischemic stroke patients with pre-existing rheumatoid arthritis is recommended in consultation with neurology.

Keywords:
arthritis and orthopaedic rheumatologyclopidogrelclopidogrel hypersensitivitymigratory arthritisoligo-arthritis

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