Brief Communications1 April 1998
    Author, Article, and Disclosure Information
    Background:

    Thrombotic thrombocytopenic purpura, a life-threatening multisystem disease, has been infrequently associated with use of ticlopidine, a platelet anti-aggregating agent.

    Purpose:

    To review 60 cases of ticlopidine-associated thrombotic thrombocytopenic purpura.

    Data Sources:

    Medical records, published case reports, and case reports submitted to the U.S. Food and Drug Administration.

    Study Selection:

    Instances of ticlopidine-associated thrombotic thrombocytopenic purpura were identified.

    Data Synthesis:

    Ticlopidine had been prescribed for less than 1 month in 80% of the patients, and normal platelet counts had been found within 2 weeks of the onset of thrombotic thrombocytopenic purpura in most patients. Mortality rates were higher among patients who were not treated with plasmapheresis than among those who underwent plasmapheresis (50% compared with 24%; P < 0.05).

    Conclusions:

    Ticlopidine use may be associated with the development of thrombotic thrombocytopenic purpura, usually within 1 month of initiation of therapy. The onset of ticlopidine-associated thrombotic thrombocytopenic purpura is difficult to predict, despite close monitoring of platelet counts.

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