https://doi.org/10.4081/itjm.2023.1660

Rare but possible: clopidogrel-induced pancytopenia

Vol. 17 No. 3 (2023)
Published: 10 October 2023
Clopidogrel, neutropenia, myocardial infarction, adverse drug reaction
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Authors

Pietro Bocchi
pietro.bocchi@ausl.pr.it
https://orcid.org/0009-0008-8939-1189
Department of Internal Medicine, Vaio Hospital, Fidenza (PR), Italy.
Pasquale Gianluca Giuri
Department of Internal Medicine, Santa Maria Hospital, Borgo Val di Taro (PR), Italy.
Achiropita Bovino
Department of Internal Medicine, Vaio Hospital, Fidenza (PR), Italy.
Alessia Casola
Department of Internal Medicine, Vaio Hospital, Fidenza (PR), Italy.
Simona Detrenis
Department of Internal Medicine, Santa Maria Hospital, Borgo Val di Taro (PR), Italy.
Marcello Bertorelli
Department of Clinical Cardiology, Cardiologic Rehabilitation and High Care Ward, Santa Maria Hospital, Borgo Val di Taro (PR), Italy.
Michele Meschi
Department of Internal Medicine, Vaio Hospital, Fidenza (PR), Italy.
Giancarlo Mangè
Department of Internal Medicine, Vaio Hospital, Fidenza (PR), Italy.

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.

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How to Cite

Bocchi, P., Giuri, P. G., Bovino, A., Casola, A., Detrenis, S., Bertorelli, M., Meschi, M., & Mangè, G. (2023). Rare but possible: clopidogrel-induced pancytopenia. Italian Journal of Medicine, 17(3). https://doi.org/10.4081/itjm.2023.1660
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