Author/Editor		Preložnik-Zupan, Irena; Zupan, Igor
Title		Trombotična trombocitopenična purpura po tiklopidinu
Translated title		Thrombotic thrombocytopenic purpura associated with ticlopidine use
Type		članek
Source		Zdrav Vestn
Vol. and No.		Letnik 69, št. 12
Publication year		2000
Volume		str. 809-11
Language		slo
Abstract		Background. Thrombotic thrombocytopenic purpura (TTP) is rare and often fatal disorder characterized by thrombocytopenia, microangiopathis hemolytic anemia, neurological simptomes and signs and dysfunction. Ticlopidine is one of several drugs that have been associated with this disorder. It is routinely used in Slovenia in patients undergoing percutaneous coronary intervention involving a stent and also in some other indications. The TTP incidence of 0.02% in ticlopidine-treated patients following coronary stenting is cosiderably higher than the estimated incidence of 0.0004% in the general population. Limiting ticlopidine therapy to 2 weeks after stenting does not prevent the development of TTP. It is essential to chesk blood cell count at least two weeks after initiating treatment with ticlopidine. Conclusions. This article presents a patient with ticlopidine associated TTP three weeks after coronary stenting. This clinical indications for ticlopidine use are expanding, and thus, serious adverse effect such as TTP are being encountered more frequently. Physicians and patients should be aware of this potentially fatal but treatable complication of ticlopidine therapy.
Summary		Izhodišča. Trombolitična trombocitopenična purpura (TTP) je redka in pogosto smrtno nevarna bolezen, ki jo označujejo trombocitopenija, mikroangiopatična hemolitična anemija, nevrološki simptomi in znaki, napredujoča prizadetost ledvic ter pogosto tudi zvečana telesna temperatura. Tiklopidin je eno izmed zdravil, povezanih s to resno boleznijo, ki ga rutinsko uporabljamo v Sloveniji pri bolnikih, pri katerih poleg perkutane transluminalne koronarne angioplastike (PTCA) uporabimo tudi žilno opornico (stent). Zdravilo uporabljamo še pri več drugih indikacijah. Incidenca TTP kot posledica zdravljenja s tiklopidinom po opravljenem stentiranju koronarnih arterij znaša v svetu 0,02% in je precej višja kot pri preostali ppulaciji (0,0004%) Tudi če skrajšamo čas zdravljenja s tiklopidinom na dva tedna, s tem ne preprečimo nastanka TTP. Pomembna je kontrola krvne slike že 14 dni po pričetku jemanja tiklopidina. Zaključki. V članku opisujemo bolnika s TTP po opravljeni PTCA in vstavitvi stenta po terh tednih jemanja tiklopidina. Zaradi širjenja indikacij za uporabo tiklopidina je možnost pojava TTP vse večja. Zdravniki in bolniki morajo biti seznanjeni s tem resnim zapletom.
Descriptors		TICLOPIDINE PURPURA, THROMBOTIC THROMBOCYTOPENIC MIDDLE AGE ANGIOPLASTY, TRANSLUMINAL, PERCUTANEOUS CORONARY