CASE REPORT article
Front. Pharmacol.
Sec. Cardiovascular and Smooth Muscle Pharmacology
Volume 16 - 2025 | doi: 10.3389/fphar.2025.1695177
Clopidogrel-induced Drug-Induced Hypersensitivity Syndrome Following Percutaneous Coronary Intervention: A Case Report of Therapeutic Dilemma and Management Strategy
Provisionally accepted
- 1Department of Gastroenterology, Taihe hospital, Hubei University of Medicine, Shiyan, Hubei Province, China
- 2Department of Emergency, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei Province, China
- 3Department of Spinal Surgery, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei Province, China
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Background: Drug-induced hypersensitivity syndrome (DIHS), also known as drug reaction with eosinophilia and systemic symptoms (DRESS), is a rare but potentially life-threatening adverse drug reaction. Clopidogrel induced DHS following percutaneous coronary intervention (PCI) presents a unique therapeutic challenge due to the critical need for dual antiplatelet therapy to prevent stent thrombosis. Case summary: A 70-year-old male underwent emergency PCI with multiple stent implantation for unstable angina with three-vessel coronary disease. Standard dual antiplatelet therapy (aspirin 100 mg daily and clopidogrel 75 mg daily) was initiated post-procedure. One hour after PCI, the patient developed anaphylactic shock initially attributed to contrast agent allergy. Two weeks post-discharge, he presented with recurrent skin rash, hypotension, gastrointestinal bleeding, fever, and eosinophilia, consistent with DIHS. Multidisciplinary consultation confirmed clopidogrel-induced DIHS using established diagnostic criteria. Despite the high risk of stent thrombosis, dual antiplatelet therapy was discontinued due to life-threatening complications. The patient was successfully managed with indobufen and low dose corticosteroids, resulting in complete symptom resolution. Conclusion: This case highlights the diagnostic complexity of clopidogrel-induced DIHS and presents the detailed account of successful management of it. Early recognition using standardized diagnostic criteria and multidisciplinary management are crucial for patient outcomes.
Keywords: clopidogrel, drug-induced hypersensitivity syndrome, DRESS syndrome, Percutaneous Coronary Intervention, Dual antiplatelet therapy, Stent thrombosis, Indobufen
Received: 29 Aug 2025; Accepted: 10 Oct 2025.
Copyright: © 2025 Wang, Zhou and Sun. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Sikun Wang, 1626334251@qq.com
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