Thrombopathy induced by selective serotonin reuptake inhibitors: a case report

We report the case of a 20 years old man presenting two episodes of hematemesis. The patient was known to suffer from depression and was treated with sertraline (Zoloft (R)) for 6 months at the dosage of 100 mg/day. No endoscopic and radiological abnormality was found. The haemostasis report was normal. Exploration of platelet function was in favor of an abnormality of platelet secretion as evidenced by low epinephrine-induced aggregation, a slightly reduced aggregation for following agonists: TRAP, ADP 5 mu M and 10 mu M, and a longer latency to collagen. The diagnosis of an acquired platelet disorder was strongly suspected and in particular an acquired platelet disorder induced by selective serotonin reuptake inhibitors that is known to interfere with platelet activation pathways involving serotonin.