Ticlopidine-Associated Thrombotic Thrombocytopenic Purpura
Authors: Charles L. Bennett
Journal: Annals of Internal Medicine (1998)

Letters15 November 1998Ticlopidine-Associated Thrombotic Thrombocytopenic PurpuraCharles L. Bennett, MD, PhD, Peter D. Weinberg, BS, and David Green, MD, PhDCharles L. Bennett, MD, PhDVeterans Affairs Healthcare System-Lakeside Division; Chicago, IL 60611Search for more papers by this author, Peter D. Weinberg, BSVeterans Affairs Healthcare System-Lakeside Division; Chicago, IL 60611Search for more papers by this author, and David Green, MD, PhDVeterans Affairs Healthcare System-Lakeside Division; Chicago, IL 60611Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-129-10-199811150-00021 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:The role of ticlopidine in causing TTP is unknown, but an immune mechanism is possible [1, 2]. An autoantibody has been described that inactivates the protease that ordinarily cleaves high-molecular-weight von Willebrand factor. Persistence of high-molecular-weight von Willebrand factor may lead to platelet adhesion, aggregation, and the formation of platelet thrombi typical of TTP. Removal of the autoantibody has been associated with the return of protease activity and remission of TTP. Ticlopidine or a metabolite may induce such an autoantibody. In our report of 60 cases of TTP among patients who received ticlopidine, the syndrome generally occurred after ...References1. Furlan M, Robles R, Solenthaler M, Wassmer M, Sandoz P, Lammle B. Deficient activity of von Willebrand factor-cleaving protease in chronic relapsing thrombotic thrombocytopenic purpura. Blood. 1997; 89:3097-103. Google Scholar2. Furlan M, Robles R, Solenthaler M, Lammle B. Acquired deficiency of von Willebrand factor-cleaving protease in a patient with thrombotic thrombocytopenic purpura. Blood. 1998; 91:2839-46. Google Scholar3. Bobbio-Pallavicini E, Gugliotta L, Centurioni R, Porta C, Vianelli N, Billio A, et al. Antiplatelet agents in thrombotic thrombocytopenic purpura. Results of a randomized, controlled trial by the Italian Cooperative Group for TTP. Haemotologica. 1997; 82:429-35. Google Scholar4. Warkentin TE, Chong BH, Greinacher A. Heparin-induced thrombocytopenia: towards consensus. Thromb Haemost. 1998; 79:1-7. Google Scholar Author, Article, and Disclosure InformationAffiliations: Veterans Affairs Healthcare System-Lakeside Division; Chicago, IL 60611 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byElectronic Structures of Reduced Manganese, Iron, and Cobalt Complexes Bearing Redox-Active Bis(imino)pyridine Pincer LigandsSynthesis, Electronic Structure, and Ethylene Polymerization Activity of Bis(imino)pyridine Cobalt Alkyl CationsSynthesis, Electronic Structure, and Ethylene Polymerization Activity of Bis(imino)pyridine Cobalt Alkyl CationsOlefin Oligomerizations and Polymerizations Catalyzed by Iron and Cobalt Complexes Bearing Bis(imino)pyridine Ligands 15 November 1998Volume 129, Issue 10Page: 837KeywordsAntibody therapyAutoantibodiesDrugsHeparinImmune responsePlatelet aggregationPlateletsProteasesThrombosisThrombotic thrombocytopenic purpura Issue Published: 15 November 1998 Copyright & PermissionsCopyright © 1998 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...