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The recently published article by Chen et al¹ reports an uncommon but important hematologic side effect of ticlopidine hydrochloride therapy. However, this article underestimates the number of reported cases of thrombotic thrombocytopenic purpura (TTP) associated with ticlopidine use. In a literature review, the authors identified and discussed only 10 cases of TTP associated with the use of ticlopidine, along with 3 patients from their institution. However, in April 1998, Bennett et al² reported 60 cases of TTP with ticlopidine use, using medical records (n=23), published case reports (n=11), and case reports submitted to the US Food and Drug Administration (n=36) as their data sources. Their findings were almost identical to those of Chen et al with regard to the onset of TTP and treatment outcome. The real incidence of this syndrome may be more common than one would interpret from the review of Chen et al.

Logan Elangovan, MD
Los . . . [Full Text of this Article]

RELATED ARTICLE

Thrombotic Thrombocytopenic Purpura Associated With Ticlopidine Use: A Report of 3 Cases and Review of the Literature
Danny K. Chen, Joseph S. Kim, and David M. C. Sutton
Arch Intern Med. 1999;159(3):311-314.
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