Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Agranulocytosis and hepatic toxicity with ticlopidine therapy: a case report. | Previtera and Pagani Journal of Medical Case Reports 2010 4 269 http content 4 1 269 JOURNALOF medical ÌỤr case REPORTS CASE REPORT Open Access Agranulocytosis and hepatic toxicity with ticlopidine therapy a case report Antonino M Previtera 1 Rossella Pagani2 Abstract Introduction Ticlopidine is a platelet inhibitor used to prevent thrombosis in patients with cerebrovascular or coronary artery disease. The most common side effects are mild and transitory diarrhea dyspepsia nausea and rashes. More serious but less frequent adverse effects are hematological dyscrasia and cholestatic hepatitis. We report a rare case of agranulocytosis associated with hepatic toxicity probably related to the use of ticlopidine. Case presentation A 70-year-old Caucasian woman with no previous history of hematological or liver diseases was treated with ticlopidine 250 mg twice daily immediately after a vertebrobasilar stroke. Upon admission her blood tests were normal. About four weeks later she developed agranulocytosis and hepatic toxicity. Ticlopidine was discontinued immediately and aspirin 25 mg and dipyridamole 200 mg were given twice daily. She was treated with hematopoietic growth factors granulocyte colony stimulating factor with a rapidly increased white blood count and progressive normalization of liver tests as a result. Conclusion In the first three months following initiation of ticlopidine therapy regular monitoring of complete blood cell count and of liver function tests is essential for the early detection of serious and unpredictable side effects. Introduction Ticlopidine is a thienopyridine derivative with platelet inhibitor capability. It acts by inhibiting the platelet aggregation induced by adenosine diphosphate and by blocking the membrane receptors of fibrinogen. It is used to prevent thrombosis in patients with cerebrovascular or coronary artery disease. Two randomized clinical studies 1 2 proved the drug s efficacy versus placebo 1 .
