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Agranlocytosis caused by ticlopindine and its mechanism
Author(s) -
Ono Kazutoshi,
Kurohara Kazuhiro,
Yoshihara Masahiro,
Shimamoto Yoshinori,
Yamaguchi Masaya
Publication year - 1991
Publication title -
american journal of hematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.456
H-Index - 105
eISSN - 1096-8652
pISSN - 0361-8609
DOI - 10.1002/ajh.2830370405
Subject(s) - ticlopidine , medicine , drug , stimulation , lymphocyte , pharmacology , immunology , myocardial infarction , clopidogrel
A 75‐year‐old female patient with agranulocytosis caused by ticlopidine is reported. She took the drug at 200 mg/day for 30 days to prevent recurrence of cerebral infarction. The leukocyte count at the nadir was 500/μl on the 34th day since she started to take the drug. Complete recovery of her peripheral leukocytes came 12 days after its withdrawal. In this patient, mechanisms of ticlopidine‐caused agranulocytosis were studied. The lymphocyte stimulation test using ticlopidine was negative. In the culture of marrow cells depleted of lymphocytes, ticlopidine directly inhibited the CFU‐C in a dose‐dependent manner. Neither the serum on the day of admission nor the T‐lymphocytes pre‐cultured with ticlopidine had any effect on the CFU‐C. The lymphocyte stimulation test is useless in an attempt to find the causal drug in agranulocytosis if it is caused in a directly toxic manner. Agranulocytosis caused by ticlopidine is rare, but careful follow‐up is necessary in the case of patients on the drug because there are some whose marrow cells are very sensitive to it.