Srpski arhiv za celokupno lekarstvo 2010 Volume 138, Issue 9-10, Pages: 632-634
https://doi.org/10.2298/SARH1010632C
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Neuroborreliosis in patient with aplastic anaemia secondary to therapy with ticlopidine
Čolović Nataša
Bumbaširević Ljiljana
Palibrk Vuk
Vidović Ana
Čolović Milica
Introduction. Aplastic anaemia is a rare but potentially fatal complication
of treatment with ticlopidine. Case Outline. We present a 55-year-old male
with aplastic anaemia which developed after 45 days of the therapy with 200
mg ticlopidine to prevent coronary thrombosis. The treatment with ticlopidine
was withdrawn and broad spectrum antibiotics as well as transfusion of packed
red cells, platelets and G-CSF were administered. Two weeks after the onset
of the disease, the number of white blood cells dropped to 0.5Č109/l, along
with drop of both haemoglobin concentration and the number of platelets. At
that time, weakness of facial muscles due to bilateral facial nerve paralysis
with Bell’s phenomenon and after that weakness of muscles of both legs and
signs of polyradiculoneuritis were developed. Western blot analysis of blood
and liquor showed a high concentration of IgG and IgM antibodies against
Borrelia burgdorferi. The treatment with cephtriaxone resulted in
normalization of body temperature and gradual recovery of neurological
findings. Blood picture became normal two months after the onset of the
disease. Conclusion. The treatment with ticlopidine may result in different
haematological complications such as agranulocytosis/ granulocytopaenia,
thrombotic trombocytopenic purpura and rarely aplastic anaemia. Due to these
complications blood pictures in patients on this therapy should be closely
followed up and in case of complications, the treatment with ticlopidine has
to be stopped and introduce the therapeutic procedures depending on the sort
of the complications and clinical presentation.
Keywords: ticlopidine, aplastic anaemia, neuroborreliosis, paralysisfacialis, polyradiculoneuritis
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