Clopidogrel-Induced Interstitial Lung Disease: A Case Report

Clopidogrel is a drug widely use for the secondary prevention of atherothrombotic complications in patients with myocardial infarction and ischemic stroke.1 This drug inhibits platelet aggregation-increasing bleeding time and reducing blood viscosity-by inhibiting the action of adenosine diphosphate (ADP) on platelet receptors.2 The adverse effects of clopidogrel are similar to those of other antiplatelet agents, such as ticlopidine or aspirin, and the most common complication is In patients, with cerebral infarction resulting from intracranial arterial stenosis, the combined administration of clopidogrel and aspirin may be needed for to prevent subsequent ischemic attacks. Clopidogrel has an inevitable adverse effect profile, and the most common complications are related to hemorrhagic propensity. A 79-year-old female patient had used aspirin (100 mg/day) for cerebral infarction and then a dual antiplatelet regimen of aspirin and clopidogrel (75 mg/day) because of severe stenosis in both anterior cerebral arteries. Two weeks later, the patient presented with dyspnea started 3 days ago, which had worsened in the last 24 hours. Chest computed tomography on admission showed symmetric peribronchial ground-glass opacity with reticulation in both lungs. Microorganism tests, including serology and bronchoalveolar lavage for infection, were all negative. Clopidogrel was withdrawn because of suspected clopidogrel-induced interstitial lung dis-ease, and steroid treatment was initiated. Clinical signs and chest radiographs improved after steroid treatment, and she was discharged on day 21 of admission. This case report shows that clopidogrel can induce interstitial lung disease as a rare complication and underscores the importance of recognizing this adverse effect in clinical practice.