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近期心肌梗死患者中氯吡格雷诱发的游走性多关节炎1例罕见病例。

A Rare Case of Clopidogrel-Induced Migratory Polyarthritis in a Patient With Recent Myocardial Infarction.

作者信息

Khan Zahid, Yousif Yousif, Mohammed Mohammed, Khan Ayub, Afghan Abdullah, Muhammad Syed Aun, Warrier Vinod, Gupta Animesh

机构信息

Cardiology, Royal Free Hospital, London, GBR.

Internal Medicine, Barking, Havering and Redbridge University Hospitals NHS Trust, London, GBR.

出版信息

Cureus. 2022 Feb 9;14(2):e22042. doi: 10.7759/cureus.22042. eCollection 2022 Feb.

Abstract

Clopidogrel is an antiplatelet drug used for secondary prevention of myocardial infarction, and it is also used in patients with cerebrovascular ischemia. Patients with acute myocardial infarction tend to be on dual antiplatelet therapy for 12 months followed by aspirin lifelong to prevent the risk of stent thrombosis. The most common side effects of clopidogrel are bleeding, neutropenia, and rash; however, arthritis is also one of the rare side effects. We present a case of a 53-year-old patient who had a recent myocardial infarction and was commenced on dual antiplatelet therapy in the form of aspirin and clopidogrel. He started to have severe joint pain, particularly in his knees and shoulders, and was not able to mobilize anymore only three weeks after starting the medications. His clopidogrel was stopped and the patient showed dramatic improvement within three to four days after discontinuation with complete resolution one week later.

摘要

氯吡格雷是一种用于心肌梗死二级预防的抗血小板药物,也用于脑血管缺血患者。急性心肌梗死患者倾向于接受12个月的双联抗血小板治疗,随后终身服用阿司匹林以预防支架血栓形成的风险。氯吡格雷最常见的副作用是出血、中性粒细胞减少和皮疹;然而,关节炎也是罕见的副作用之一。我们报告一例53岁的患者,他最近发生了心肌梗死,并开始接受阿司匹林和氯吡格雷形式的双联抗血小板治疗。他开始出现严重的关节疼痛,尤其是膝盖和肩膀,在开始用药仅三周后就无法再活动了。停用了他的氯吡格雷,患者在停药后三到四天内症状显著改善,一周后完全缓解。

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Clopidogrel-Induced Recurrent Polyarthritis.氯吡格雷诱发的复发性多关节炎
J Investig Med High Impact Case Rep. 2013 Aug 5;1(3):2324709613500239. doi: 10.1177/2324709613500239. eCollection 2013 Jul-Sep.

本文引用的文献

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Clopidogrel: a review of its mechanism of action.氯吡格雷:其作用机制综述
Platelets. 1998;9(3-4):251-5. doi: 10.1080/09537109876799.
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Clopidogrel-associated acute arthritis.氯吡格雷相关性急性关节炎
Intern Med J. 2003 Dec;33(12):618-9. doi: 10.1111/j.1445-5994.2003.00496.x.

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