Hemolytic Uremic Syndrome with Clopidogrel after Coronary Angioplasty

Korean J Med > Volume 80(2); 2011 > Article

Original Article

The Korean Journal of Medicine 2011;80(2):253-257.

Hemolytic Uremic Syndrome with Clopidogrel after Coronary Angioplasty

Si-Hyung Park1, Jin-Han Park1, Sang-Yool Park1, Eun-Ji Lee1, Hyun-Soo Jun1, Yeong-Hoon Kim1, Yang-Wook Kim2

관상동맥 성형술 시행한 환자에서 Clopidogrel과 관련된 용혈성 요독증후군

박시형1, 박진한1, 박상율1, 이은지1, 전현수1, 김영훈1, 김양욱2

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.

Key Words: Clopidogrel; Hemolytic uremic syndrome