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J Neurol Surg Rep 2015; 76(02): e287-e290
DOI: 10.1055/s-0035-1566127
Case Report
Georg Thieme Verlag KG Stuttgart · New York

Clopidogrel-Associated Thrombotic Thrombocytopenic Purpura following Endovascular Treatment of Spontaneous Carotid Artery Dissection

Jerry A. Rubano
1   Division of Trauma, Department of Surgery, Stony Brook University School of Medicine, Stony Brook, New York, United States
,
Kwan Chen
2   Stony Brook University School of Medicine, Stony Brook, New York, United States
,
Brianne Sullivan
2   Stony Brook University School of Medicine, Stony Brook, New York, United States
,
James A. Vosswinkel
1   Division of Trauma, Department of Surgery, Stony Brook University School of Medicine, Stony Brook, New York, United States
,
Randeep S. Jawa
1   Division of Trauma, Department of Surgery, Stony Brook University School of Medicine, Stony Brook, New York, United States
› Author Affiliations
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Publication History

25 June 2015

19 August 2015

Publication Date:
25 October 2015 (online)

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Abstract

Thrombotic thrombocytopenic purpura (TTP) is a life-threatening multisystem disease secondary to platelet aggregation. We present a patient who developed profound thrombocytopenia and anemia 8 days following initiation of therapy with clopidogrel after stent placement for carotid artery dissection. She did not have a disintegrin and metalloproteinase with thrombospondin domain 13 (ADAMTS 13) deficiency. Management included steroids and therapeutic plasma exchange. Clopidogrel has rarely been associated with TTP. Unlike other causes of acquired TTP, the diagnosis of early clopidogrel-associated TTP is largely clinical given the infrequent reduction in ADAMTS 13 activity.

Keywords

clopidogrel - TTP - carotid - stent - thrombocytopenia
 

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