{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T14:35:21Z","timestamp":1787841321393,"version":"build-2784847793"},"reference-count":13,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","license":[{"start":{"date-parts":[[2016,4,1]],"date-time":"2016-04-01T00:00:00Z","timestamp":1459468800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2015,11,25]],"date-time":"2015-11-25T00:00:00Z","timestamp":1448409600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2016,4]]},"abstract":"<jats:sec>\n                    <jats:title\/>\n                    <jats:p>Thrombotic thrombocytopenic purpura (TTP) is a multisystem disorder characterized by microvascular aggregation of platelets and fibrin strands causing thrombocytopenia, microangiopathic hemolytic anemia, and organ dysfunction. TTP can develop as a result of a deficiency in ADAMTS13 enzyme activity due to either a genetic defect or, more commonly, the development of anti-ADAMTS13 autoantibodies. TTP can also be associated with pregnancy, organ transplant, lupus, infections, and drugs. Here, we present a case of TTP that developed shortly after the start of clopidogrel treatment for acute ischemic stroke and acute myocardial infarction, and describe the clinical presentation, refractory course of the disease, and successful induction of remission through the use of rituximab in a setting of pre-existing autoimmune diseases.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1016\/j.hemonc.2015.11.003","type":"journal-article","created":{"date-parts":[[2015,12,2]],"date-time":"2015-12-02T03:16:42Z","timestamp":1449026202000},"page":"76-79","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":9,"title":["Clopidogrel-induced refractory thrombotic thrombocytopenic purpura successfully treated with rituximab"],"prefix":"10.4103","volume":"9","author":[{"given":"Sara","family":"Khodor","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miguel","family":"Castro","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Colin","family":"McNamara","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chakra P.","family":"Chaulagain","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"10.1016\/j.hemonc.2015.11.003_b0005","doi-asserted-by":"crossref","first-page":"2142","DOI":"10.1093\/ndt\/gfh230","article-title":"Underestimated complications in thrombotic thrombocytopenic purpura\u2014haemolytic uraemic syndrome","volume":"19","author":"Brandenburg","year":"2004","journal-title":"Nephrol Dial Transplant"},{"key":"10.1016\/j.hemonc.2015.11.003_b0010","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1182\/blood-2008-02-078170","article-title":"Von Willebrand factor, ADAMTS13, and thrombotic thrombocytopenic purpura","volume":"112","author":"Sadler","year":"2008","journal-title":"Blood"},{"key":"10.1016\/j.hemonc.2015.11.003_b0015","doi-asserted-by":"crossref","first-page":"437","DOI":"10.1053\/beha.2001.0142","article-title":"Aetiology and pathogenesis of thrombotic thrombocytopenic purpura and haemolytic uraemic syndrome: the role of von Willebrand factor-cleaving protease","volume":"14","author":"Furlan","year":"2001","journal-title":"Best Pract Res Clin Haematol"},{"key":"10.1016\/j.hemonc.2015.11.003_b0020","doi-asserted-by":"crossref","first-page":"1500","DOI":"10.1182\/blood-2009-09-243790","article-title":"Survival and relapse in patients with thrombotic thrombocytopenic purpura","volume":"115","author":"Kremer Hovinga","year":"2010","journal-title":"Blood"},{"key":"10.1016\/j.hemonc.2015.11.003_b0025","doi-asserted-by":"crossref","first-page":"3161","DOI":"10.1182\/blood-2005-07-2765","article-title":"Complete deficiency in ADAMTS13 is prothrombotic, but it alone is not sufficient to cause thrombotic thrombocytopenic purpura","volume":"107","author":"Banno","year":"2006","journal-title":"Blood"},{"key":"10.1016\/j.hemonc.2015.11.003_b0030","doi-asserted-by":"crossref","first-page":"2752","DOI":"10.1172\/JCI26007","article-title":"Shigatoxin triggers thrombotic thrombocytopenic purpura in genetically susceptible ADAMTS13-deficient mice","volume":"115","author":"Motto","year":"2005","journal-title":"J Clin Invest"},{"key":"10.1016\/j.hemonc.2015.11.003_b0035","doi-asserted-by":"crossref","first-page":"856","DOI":"10.1111\/j.1538-7836.2010.03772.x","article-title":"HLA-DRB1\u221711: a strong risk factor for acquired severe ADAMTS13 deficiency-related idiopathic thrombotic thrombocytopenic purpura in Caucasians","volume":"8","author":"Coppo","year":"2010","journal-title":"J Thromb Haemost"},{"key":"10.1016\/j.hemonc.2015.11.003_b0040","doi-asserted-by":"crossref","first-page":"323","DOI":"10.1111\/j.1365-2141.2012.09167.x","article-title":"Guidelines on the diagnosis and management of thrombotic thrombocytopenic purpura and other thrombotic microangiopathies","volume":"158","author":"Scully","year":"2012","journal-title":"Br J Haematol"},{"key":"10.1016\/j.hemonc.2015.11.003_b0045","first-page":"771","article-title":"Thrombotic thrombocytopenic purpura associated with clopidogrel: further evaluation","volume":"18","author":"Paradiso-Hardy","year":"2002","journal-title":"Can J Cardiol"},{"key":"10.1016\/j.hemonc.2015.11.003_b0050","doi-asserted-by":"crossref","first-page":"1138","DOI":"10.1016\/j.jacc.2007.04.093","article-title":"Two mechanistic pathways for thienopyridine-associated thrombotic thrombocytopenic purpura: a report from the SERF-TTP Research Group and the RADAR Project","volume":"50","author":"Bennett","year":"2007","journal-title":"J Am Coll Cardiol"},{"key":"10.1016\/j.hemonc.2015.11.003_b0055","doi-asserted-by":"crossref","first-page":"592","DOI":"10.1309\/RLNMJ01WBJRNLH03","article-title":"Rituximab can be combined with daily plasma exchange to achieve effective B-cell depletion and clinical improvement in acute autoimmune TTP","volume":"125","author":"Darabi","year":"2006","journal-title":"Am J Clin Pathol"},{"key":"10.1016\/j.hemonc.2015.11.003_b0060","doi-asserted-by":"crossref","first-page":"1","DOI":"10.4137\/CMBD.S25326","article-title":"Efficacy and safety of rituximab for refractory and relapsing thrombotic thrombocytopenic purpura: a cohort of 10 cases","volume":"8","author":"Omri","year":"2015","journal-title":"Clin Med Insights Blood Disord"},{"key":"10.1016\/j.hemonc.2015.11.003_b0065","doi-asserted-by":"crossref","first-page":"204","DOI":"10.1182\/blood-2014-01-550244","article-title":"Preemptive rituximab infusions after remission efficiently prevent relapses in acquired thrombotic thrombocytopenic purpura","volume":"124","author":"Hie","year":"2014","journal-title":"Blood"}],"container-title":["Hematology\/Oncology and Stem Cell Therapy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1658387615001053?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1658387615001053?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.ovid.com\/02275670-201609020-00006","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T13:48:41Z","timestamp":1787838521000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/02275670-201609020-00006"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,4]]},"references-count":13,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2016]]}},"URL":"https:\/\/doi.org\/10.1016\/j.hemonc.2015.11.003","relation":{},"ISSN":["1658-3876"],"issn-type":[{"value":"1658-3876","type":"print"}],"subject":[],"published":{"date-parts":[[2016,4]]}}}