Korean J Med.  2011 Jun;80(Suppl 2):S253-S257.

Hemolytic Uremic Syndrome with Clopidogrel after Coronary Angioplasty

• Park SH
• Park JH
• Park SY
• Lee EJ
• Jun HS
• Kim YH
• Kim YW

Abstract

Thienopyridines are antiplatelet agents used in post-percutaneous coronary angioplasty patients and patients with acute coronary syndrome, stroke, and peripheral arterial disease. Ticlopidine has been shown to reduce the incidence of stent thrombosis, but it may also cause serious hematological side effects. Among the thienopyridines, clopidogrel is considered to be a safe alternative to ticlopidine because of its decreased incidence of hematological adverse effects. However, some hematological side effects can occur and may be fatal. In this case, a 47-year-old man complained of dyspnea and generalized edema. He had been taking clopidogrel after coronary angioplasty. His laboratory findings showed acute renal failure, microangiopathic hemolytic anemia, and thrombocytopenia, which were consistent with hemolytic uremic syndrome (HUS). After discontinuing clopidogrel and undergoing plasma exchange, he recovered fully. To our knowledge, this is the first reported case of clopidogrel-induced HUS in Korea.

Keyword

Clopidogrel; Hemolytic uremic syndrome

MeSH Terms

Acute Coronary Syndrome
Acute Kidney Injury
Anemia, Hemolytic
Angioplasty
Dyspnea
Edema
Hemolytic-Uremic Syndrome
Humans
Incidence
Korea
Middle Aged
Peripheral Arterial Disease
Plasma Exchange
Platelet Aggregation Inhibitors
Stents
Stroke
Thienopyridines
Thrombocytopenia
Thrombosis
Ticlopidine
Platelet Aggregation Inhibitors
Thienopyridines
Ticlopidine