Kodama K, Nomura T, Yasui K, Matsuo T
Department of Internal Medicine, Hyogo Prefectural Awaji Hospital.
Rinsho Ketsueki. 1996 Nov;37(11):1334-6.
On June 29, 1995, a 49-year-old man was admitted with acute onset of fever, petechiae on his legs, and mental confusion He had suffered hypertension since 6 months previously and was on nicardipine (60 mg/day), ifenprodil (60 mg/day) and ticlopidine (300 mg/day). He had been on ticlopidine for 4 weeks and on the other drugs for 6 months. Soon after admission he had frequent grand mal seizures and needed mechanical ventilation. A diagnosis of TTP was made. He was treated with plasmapheresis (50 ml/kg per day), aspirin 81 mg/day and dipyridamole 300 mg/day. On the sixth day his mental status returned to normal. He recovered gradually from microangiopathic hemolytic anemia, thrombocytopenia and elevated serum creatinine. We reviewed the literature and discussed the possible mechanism of TTP related to the use of ticlopidine.
1995年6月29日，一名49岁男性因突发发热、腿部瘀点和精神错乱入院。他6个月前开始患高血压，一直服用尼卡地平（60毫克/天）、艾芬地尔（60毫克/天）和噻氯匹定（300毫克/天）。他服用噻氯匹定4周，服用其他药物6个月。入院后不久，他频繁发生癫痫大发作，需要机械通气。诊断为血栓性血小板减少性紫癜（TTP）。给予他血浆置换治疗（每天50毫升/千克）、阿司匹林81毫克/天和双嘧达莫300毫克/天。第六天，他的精神状态恢复正常。他逐渐从微血管病性溶血性贫血、血小板减少和血清肌酐升高的状态中恢复。我们查阅了文献并讨论了与使用噻氯匹定相关的TTP的可能机制。
