Clopidogrel-induced hemarthrosis following knee replacement
-
Abel Chundankuzhiyil Mathew
,
Athira Poothankandi
Abstract
Background
Clopidogrel is an adenosine diphosphate receptor antagonist used in patients with atherosclerotic vascular disease to reduce the incidence of ischemic events.
Case Presentation
A 62-year-old woman developed a spontaneous hemarthrosis of her left knee following clopidogrel treatment. To date, no case of spontaneous hemarthrosis following clopidogrel monotherapy was reported. Prompt aspiration after discontinuing clopidogrel by conservative management can assist early diagnosis and prevent further damage to the joint. The assessment of the causality of the event was carried out via Naranjo Causality Assessment Scale. A score of 5 was reported for this patient, indicating clopidogrel as a probable cause of this reaction.
Conclusion
We conclude that spontaneous hemarthrosis is a possible complication following clopidogrel therapy and it needs assessment when appropriate clinical symptoms (e.g. intra-articular effusion, pain) are present.
Author contributions: All authors have accepted responsibility for the entire content of this submitted manuscript and approved its submission.
Research funding: None declared.
Employment or leadership: None declared.
Honorarium: None declared.
Competing interests: Authors state no conflict of interest.
Informed consent: The authors wish to thank the patient and her caregivers who kindly gave consent for their case to be presented in this report.
Ethical approval: Research involving human subjects complies with all relevant national regulations, institutional policies and is in accordance with the tenets of the Helsinki Declaration (as revised in 2013), and has been approved by the authors’ institutional review board (xxxx) or equivalent committee. (xxx-Nr.: xx/x).
References
[1] Tripathi KD. Essentials of medical pharmacology, 7th Ed. New Delhi: Jaypee Brothers Medical Publishers, 2013:630.10.5005/jp/books/12256Suche in Google Scholar
[2] UpToDate. Overview of hemarthrosis. Available at: https://www.uptodate.com/contents/overview-of-hemarthrosis. Accessed: 5 Apr 2019.Suche in Google Scholar
[3] Wild JH, Zvaifler NJ. Hemarthrosis associated with sodium warfarin therapy. Arthritis Rheum 1976;19:98–102.10.1002/art.1780190117Suche in Google Scholar PubMed
[4] Katz AL, Alepa FP. Hemarthrosis secondary to heparin therapy. Arthritis Rheum 1976;19:966.10.1002/art.1780190530Suche in Google Scholar PubMed
[5] Gille J, Bernotat J, Böhm S, Behrens P, Löhr JF. Spontaneous hemarthrosis of the knee associated with clopidogrel and aspirin treatment. Z Rheumatol 2003;62:80–1.10.1007/s00393-003-0420-3Suche in Google Scholar PubMed
[6] Kindsfater KA. Recurrent hemarthrosis after total knee arthroplasty. J Arthroplasty 1995;10:S52–5.10.1007/978-3-642-87202-0_25Suche in Google Scholar
[7] Yoo J-H, Oh H-C, Park S-H, Lee S, Lee Y, Kim S-H. Treatment of recurrent hemarthrosis after total knee arthroplasty. Knee SurgRelat Res 2018;30:147–52.10.5792/ksrr.17.059Suche in Google Scholar PubMed PubMed Central
[8] Tsukada S, Wakui M. Continuing versus discontinuing antiplatelet drugs, vasodilators, and/or cerebral ameliorators on perioperative total blood loss in total knee arthroplasty without pneumatic tourniquet. Arthroplast Today 2017;4:89–93.10.1016/j.artd.2017.07.002Suche in Google Scholar PubMed PubMed Central
© 2019 Walter de Gruyter GmbH, Berlin/Boston
Artikel in diesem Heft
- Review
- Cardioprotective mechanism of FTY720 in ischemia reperfusion injury
- Original Articles
- Effect of Gmelina arborea on learning and memory in amnesia-induced and non-amnesia groups of albino Wistar rats
- The acute effects of decaffeinated versus caffeinated coffee on reaction time, mood and skeletal muscle strength
- Prevention of short-term memory impairment by Bryophyllum pinnatum (Lam.) Oken and its effect on acetylcholinesterase changes in CCl4-induced neurotoxicity in rats
- Modulatory effects of artichoke (Cynara scolymus L.) leaf extract against oxidative stress and hepatic TNF-α gene expression in acute diazinon-induced liver injury in rats
- Evaluation of biomarkers of stress in chronic stress-exposed comorbid depression model Wistar rats
- Drospirenone-containing oral contraceptives do not affect glucose regulation and circulating corticosterone
- Vitamin C, omega-3 and paracetamol pharmacokinetic interactions using saliva specimens as determiners
- Comparison of ocular pharmacokinetics of etoposide and its nanoemulsion after subtenon administration in rabbits
- Exploring the therapeutic potential of sodium benzoate in acetic acid-induced ulcerative colitis in rats
- Short Communication
- HPLC phenolic fingerprinting, antioxidant and anti-phosphodiesterase-5 properties of Rauwolfia vomitoria extract
- Miscellaneous
- Clopidogrel-induced hemarthrosis following knee replacement
Artikel in diesem Heft
- Review
- Cardioprotective mechanism of FTY720 in ischemia reperfusion injury
- Original Articles
- Effect of Gmelina arborea on learning and memory in amnesia-induced and non-amnesia groups of albino Wistar rats
- The acute effects of decaffeinated versus caffeinated coffee on reaction time, mood and skeletal muscle strength
- Prevention of short-term memory impairment by Bryophyllum pinnatum (Lam.) Oken and its effect on acetylcholinesterase changes in CCl4-induced neurotoxicity in rats
- Modulatory effects of artichoke (Cynara scolymus L.) leaf extract against oxidative stress and hepatic TNF-α gene expression in acute diazinon-induced liver injury in rats
- Evaluation of biomarkers of stress in chronic stress-exposed comorbid depression model Wistar rats
- Drospirenone-containing oral contraceptives do not affect glucose regulation and circulating corticosterone
- Vitamin C, omega-3 and paracetamol pharmacokinetic interactions using saliva specimens as determiners
- Comparison of ocular pharmacokinetics of etoposide and its nanoemulsion after subtenon administration in rabbits
- Exploring the therapeutic potential of sodium benzoate in acetic acid-induced ulcerative colitis in rats
- Short Communication
- HPLC phenolic fingerprinting, antioxidant and anti-phosphodiesterase-5 properties of Rauwolfia vomitoria extract
- Miscellaneous
- Clopidogrel-induced hemarthrosis following knee replacement
