⚡AN 80-YEAR-OLD MAN WITH ISCHEMIC HEART DISEASE WHO DEVELOPED THROMBOTIC THROMBOCYTOPENIC PURPURA (TTP) FOLLOWING TREATMENT WITH TICAGRELOR. 👀In the photo: Peripheral blood smear from the patient before plasma exchange therapy, which revealed numerous acanthocytes, schistocytes, erythrocyte fragments, polychromasia, occasional spherocytes, large platelets, and a reduced platelet count, generally consistent with microangiopathic hemolytic anemia.
Thrombotic thrombocytopenic purpura (TTP) is associated with widespread microvascular thrombosis, low platelet count, and hemolysis. Ticagrelor is a relatively new drug that acts as a reversible P2Y12 receptor inhibitor, preventing platelet aggregation, and is used with or without aspirin in patients with acute coronary syndrome to reduce the risk of myocardial infarction and stroke. A new clinical case from an American journal describes the case of an 80-year-old man with ischemic heart disease who developed this rare and potentially fatal adverse reaction, known as TTP, after treatment with ticagrelor. A case is reported of an 80-year-old man who developed an acute change in mental status 4 months after starting ticagrelor treatment following percutaneous coronary intervention. Laboratory studies upon admission revealed signs of microangiopathic hemolytic anemia, thrombocytopenia, and elevated creatinine levels, indicating acute kidney injury. The combination of his clinical symptoms and laboratory findings suggested TTP, likely secondary to ticagrelor use. The patient underwent therapeutic plasma exchange, received systemic steroids, and hemodialysis, which led to the resolution of hemolysis and restoration of kidney function.
👉🏻Conclusions. Although the association between ticagrelor and TTP is rare, early detection of this life-threatening complication is essential to reduce TTP-related morbidity and mortality. As ticagrelor is now used more frequently, it is important for clinicians to be aware of this complication.
Source: Jarrett S. A. et al. An 80-Year-Old Man with Ischemic Heart Disease Who Developed Thrombotic Thrombocytopenic Purpura Following Treatment with Ticagrelor //The American journal of case reports. – 2022. – Т. 23. – С. e936977.
