{"title":"罕见但可能:氯吡格雷引起的全细胞减少症","authors":"Pietro Bocchi, Pasquale Gianluca Giuri, Achiropita Bovino, Alessia Casola, Simona Detrenis, Marcello Bertorelli, Michele Meschi, Giancarlo Mangè","doi":"10.4081/itjm.2023.1660","DOIUrl":null,"url":null,"abstract":"We present the case of an 84-year-old female patient admitted to the Internal Medicine Ward for atypical chest pain and laboratory findings of severe pancytopenia. Past medical history was remarkable for an episode of myocardial infarction approximately 4 weeks prior to the current hospitalization which had required angioplasty + drug-eluting stent and dual antiplatelet therapy with acetylsalicylic acid and clopidogrel. Some rare cases of clopidogrel-induced pancytopenia are described in scientific literature, therefore, after excluding infectious, vitamin deficiencies, and autoimmune causes, we modified the antiplatelet therapy by replacing clopidogrel with ticagrelor, obtaining complete leukocyte recovery within a few days. Since clopidogrel is an antiplatelet drug still used in clinical cardiological practice, the knowledge of this rare side effect may lead the clinician to suspect hematological toxicity which, if recognized promptly, may suggest modification of antiplatelet therapy and limit any possible infectious complications for the care of the patient.","PeriodicalId":43715,"journal":{"name":"Italian Journal of Medicine","volume":"16 1","pages":"0"},"PeriodicalIF":0.3000,"publicationDate":"2023-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"1","resultStr":"{\"title\":\"Rare but possible: clopidogrel-induced pancytopenia\",\"authors\":\"Pietro Bocchi, Pasquale Gianluca Giuri, Achiropita Bovino, Alessia Casola, Simona Detrenis, Marcello Bertorelli, Michele Meschi, Giancarlo Mangè\",\"doi\":\"10.4081/itjm.2023.1660\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"We present the case of an 84-year-old female patient admitted to the Internal Medicine Ward for atypical chest pain and laboratory findings of severe pancytopenia. Past medical history was remarkable for an episode of myocardial infarction approximately 4 weeks prior to the current hospitalization which had required angioplasty + drug-eluting stent and dual antiplatelet therapy with acetylsalicylic acid and clopidogrel. Some rare cases of clopidogrel-induced pancytopenia are described in scientific literature, therefore, after excluding infectious, vitamin deficiencies, and autoimmune causes, we modified the antiplatelet therapy by replacing clopidogrel with ticagrelor, obtaining complete leukocyte recovery within a few days. Since clopidogrel is an antiplatelet drug still used in clinical cardiological practice, the knowledge of this rare side effect may lead the clinician to suspect hematological toxicity which, if recognized promptly, may suggest modification of antiplatelet therapy and limit any possible infectious complications for the care of the patient.\",\"PeriodicalId\":43715,\"journal\":{\"name\":\"Italian Journal of Medicine\",\"volume\":\"16 1\",\"pages\":\"0\"},\"PeriodicalIF\":0.3000,\"publicationDate\":\"2023-10-10\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"1\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Italian Journal of Medicine\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.4081/itjm.2023.1660\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"MEDICINE, GENERAL & INTERNAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Italian Journal of Medicine","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.4081/itjm.2023.1660","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
Rare but possible: clopidogrel-induced pancytopenia
We present the case of an 84-year-old female patient admitted to the Internal Medicine Ward for atypical chest pain and laboratory findings of severe pancytopenia. Past medical history was remarkable for an episode of myocardial infarction approximately 4 weeks prior to the current hospitalization which had required angioplasty + drug-eluting stent and dual antiplatelet therapy with acetylsalicylic acid and clopidogrel. Some rare cases of clopidogrel-induced pancytopenia are described in scientific literature, therefore, after excluding infectious, vitamin deficiencies, and autoimmune causes, we modified the antiplatelet therapy by replacing clopidogrel with ticagrelor, obtaining complete leukocyte recovery within a few days. Since clopidogrel is an antiplatelet drug still used in clinical cardiological practice, the knowledge of this rare side effect may lead the clinician to suspect hematological toxicity which, if recognized promptly, may suggest modification of antiplatelet therapy and limit any possible infectious complications for the care of the patient.