Letters to the Editor: Nonfatal aplastic anemia associated with clopidogrel

Thienopyridines inhibit the adenosine 5 -diphosphate P2Y12 receptor on platelets. These drugs reduce the overall rate of thromboembolic events in patients with atherosclerotic vascular disease after stent implantation. Ticlopidine is a first-generation thienopyridine. The use of ticlopidine has two major limitations, which are its safety profile and its inability to induce platelet inhibition rapidly. Thus, clopidogrel, a second-generation thienopyridine, has largely replaced ticlopidine. Clopidogrel therapy may also be accompanied by rare life-threatening side effects (1). Clopidogrel may be found to be associated with severe bone marrow suppression manifested as bone marrow failure (2), aplastic anemia, thrombocytopenia, neutropenia. We present a case of aplastic anemia caused by clopidogrel.