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Inicio Allergologia et Immunopathologia Immediate hypersensitivity and delayed hypersensitivity to Clopidogrel
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Vol. 35. Issue 5.
Pages 213-215 (September 2007)
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Vol. 35. Issue 5.
Pages 213-215 (September 2007)
DOI: 10.1157/13110317
Immediate hypersensitivity and delayed hypersensitivity to Clopidogrel
Hipersensibilidad inmediata e hipersensibilidad retardada al clopidogrel
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D. Gutiérrez-Fernándeza, MS. Fuentes-Vallejob, MD. Rueda-Ygueravidesa, A. Foncubierta-Fernándezc, A. León-Jiméneza
a Servicio de Neumología-Alergia. Hospital Puerta del Mar. Cádiz. Spain.
b Alergomedic-Clínicas de Alergia y Asma. Cádiz. Spain.
c Centro de Salud Joaquín Pece. San Fernando. Cádiz. Spain.
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Table. I Oral provocation protocol with clopidogrel (Plavix®):
Clopidogrel is a new antiplatelet prescribed for the secondary prevention of atherosclerotic events. The literature shows that the clinical manifestations of clopidogrel hypersensitivity include urticaria1, skin rash2-4, and angioedema5. The precise immunological mechanism underlying clopidogrel hypersensitivity has not been established. We describe two cases of hypersensitivity reaction due to clopidogrel. The first constituted an immediate reaction after clopidogrel intake. In this case we demonstrated type 1 hypersensitivity using cutaneous tests. The second case represented a delayed hypersensitivity reaction confirmed by oral challenge testing, in which good tolerance to other antiplatelet drugs such as ticlopidine was demonstrated.
Keywords:
allergy, antiplatelet, clopidogrel, drug desensitization, hypersensitivity reaction
El Clopidogrel (Plavit), es un nuevo antiagregante plaquetario, indicado en la prevención secundaria de eventos ateroescleróticos. En la bibliografía, las manifestaciones clínicas descritas por hipersensibilidad al clopidogrel incluyen urticaria, rash cutáneo y angioedema. El mecanismo inmunológico preciso de la hipersensibilidad al Clopidogrel no ha sido elucidado. Describimos dos casos de reacciones de hipersensibilidad por Clopidogrel. El primer caso se trata de una reacción inmediata tras la administración de Clopidogrel, en él demostramos hipersensibilidad de tipo I mediante pruebas cutáneas. El segundo caso se trata de una reacción tardía por sensibilización tipo IV al Clopidogrel, confirmada con prueba de provocación oral en el cual además demostramos buena tolerancia a otros antiagregantes plaquetarios como la Ticlopidina.

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