Agrawal Sahil, Harburger Joseph, Stallings Gary, Agrawal Nikhil, Garg Jalaj
Department of Internal Medicine, Westchester Medical Center, New York Medical College, Valhalla, NY, USA.
Division of Cardiology, Department of Internal Medicine, Westchester Medical Center, New York Medical College, Valhalla, NY, USA.
J Investig Med High Impact Case Rep. 2013 Aug 5;1(3):2324709613500239. doi: 10.1177/2324709613500239. eCollection 2013 Jul-Sep.
Clopidogrel is an oral thienopyridine and together with aspirin is a component of dual antiplatelet therapy for the prevention of stent thrombosis after intracoronary stent placement. The common adverse effects from its use are an increased risk of bleeding, neutropenia, and rash. Arthralgia and backache are also known to occur with its use. There have been case reports linking arthritis with the use of clopidogrel. We describe the case of a 64-year-old man who reported symptoms of fever and joint pains following initiation of therapy with clopidogrel. Acute-phase reactants were elevated. Laboratory and radiologic testing were unremarkable. Incidentally, he reported experiencing a similar arthritis after he received a loading dose of clopidogrel prior to a diagnostic coronary angiography in the past. The symptoms improved dramatically on discontinuation of clopidogrel. There was no recurrence of symptoms with prasugrel. This describes possibly the second incidence of recurrent arthritis with clopidogrel therapy.
氯吡格雷是一种口服噻吩并吡啶类药物，与阿司匹林一起是双重抗血小板治疗的组成部分，用于预防冠状动脉内支架置入术后的支架血栓形成。使用它的常见不良反应是出血风险增加、中性粒细胞减少和皮疹。已知使用它时也会出现关节痛和背痛。有病例报告将关节炎与氯吡格雷的使用联系起来。我们描述了一名64岁男性的病例，他在开始使用氯吡格雷治疗后出现发热和关节疼痛症状。急性期反应物升高。实验室和影像学检查无异常。顺便提一下，他报告称过去在诊断性冠状动脉造影前接受氯吡格雷负荷剂量后曾经历过类似的关节炎。停用氯吡格雷后症状显著改善。使用普拉格雷后症状未复发。这可能描述了氯吡格雷治疗复发性关节炎的第二例病例。
