2026, Number 3
Cardiovasc Metab Sci 2026; 37 (3)
Clopidogrel-associated small vessel vasculitis in acute coronary syndrome: a diagnostic and therapeutic challenge
Velásquez-Ospina, Juanita; Pamplona-Tobón, Jorge Alejandro; Mejía-Zapata, Natalia; Patiño-Giraldo, Santiago; Gaviria-Aguilar, María Clara
ABSTRACT
The treatment of acute coronary syndrome includes the use of acetylsalicylic acid and a P2Y12 inhibitor, with clopidogrel being the most commonly used agent in clinical practice. Fortunately, hypersensitivity reactions to clopidogrel are uncommon; however, when they occur, they are typically type I reactions mediated by IgE (e.g., urticaria, angioedema, and cutaneous rash). Type III hypersensitivity reactions, such as small vessel vasculitis, are exceedingly rare and pose a therapeutic challenge, particularly in the setting of acute coronary syndrome (ACS). This case report shows an uncommon presentation that should be considered in patients receiving antiplatelet therapy.