Carotid Artery Thrombus Associated With Severe Iron-Deficiency Anemia and Thrombocytosis

Akins, Paul T.; Glenn, Susan Wagner; Nemeth, P. M.; Derdeyn, Colin P.

doi:10.1161/01.str.27.5.1002

Cited by 125 publications

(121 citation statements)

References 21 publications

Supporting

Mentioning

113

Contrasting

Unclassified

Order By: Relevance

“…This increased blood flow can cause vascular endothelial damage, resulting in thrombus formation. The authors of a previous report of three cases of ischemic stroke in patients with IDA considered that the thrombocytosis could have acted synergistically with the anemia to promote thrombogenesis in the carotid artery, especially with underlying atherosclerotic disease (14). The subcortical border-zone areas are particularly susceptible to ischemia when there is reduced cerebral blood flow and oxygen supply.…”

Section: Discussionmentioning

confidence: 99%

Two Cases of Acute Ischemic Stroke Associated with Iron Deficiency Anemia due to Bleeding from Uterine Fibroids in Middle-aged Women

et al. 2014

View full text Add to dashboard Cite

We herein report two cases of acute ischemic stroke associated with iron deficiency anemia (IDA) due to bleeding from uterine fibroids. Anemia is not generally recognized as a risk factor for stroke. The physiological mechanisms that may factor in the development of ischemic stroke in patients with IDA include thrombocytosis, hypercoagulable state, and anemic hypoxia. In our two cases, IDA was considered to be the cause of ischemic stroke because all other known causes of stroke were ruled out. In patients with ischemic stroke due to anemia, early treatment of the anemia is important to prevent stroke recurrence.

show abstract

Section: Discussionmentioning

confidence: 99%

Two Cases of Acute Ischemic Stroke Associated with Iron Deficiency Anemia due to Bleeding from Uterine Fibroids in Middle-aged Women

et al. 2014

View full text Add to dashboard Cite

show abstract

“…Thrombus unrelated to the atheromatous plaque in the cervical carotid artery has been reported in only five cases, possibly originating in valvular strands on the aortic valve, thrombocythemia, and anemia. 1,4) All cases including our case could exclude the underlying vascular atheromatous lesion of the cervical carotid artery. Our case did not have known causes such as cardiac and hematological disorders, and furthermore recurred, so this type of thrombus is extremely rare.…”

Section: Discussionmentioning

confidence: 79%

Repeated Thrombus Formation Immediately Following Carotid Endarterectomy-Case Report-

Yoshimoto¹,

Aoyama²,

Shirasaka³

et al. 2003

Neurol. Med. Chir.(Tokyo)

View full text Add to dashboard Cite

A 56-year-old male presented with thrombus formation manifesting as cerebral embolic infarction suspected to be caused by hemostasis at the carotid bifurcation, not by the intimal abnormalities or hematological disorders. Thrombus repeatedly and reproducibly appeared at the same area in spite of carotid endarterectomy (CEA). Ultrasonography demonstrated a stenotic lesion of the cervical carotid bifurcation. Medical treatment reduced the stenosis, but the thrombus was repeatedly formed at the same area of the cervical carotid bifurcation. CEA was performed. Histological examination of the specimen found only the underlying thin intima consisting of mild fibrous atheromatic change without ulceration or vascular dissection. Ultrasonography following CEA showed reduced blood flow, indicating hemostasis, and moyamoya appearance in that area. The thrombus had recurred in spite of the medical treatment with anti-platelet agent. This repeated thrombus was gradually dissolved and reduced with anticoagulant therapy. Thrombus causing cerebral embolic stroke and originating at the cervical carotid bifurcation is usually due to the intimal atherosclerotic change such as ulcer formation or vascular dissection. The thrombus in this case was probably formed by hemostasis at the cervical carotid bifurcation and CEA was not effective to prevent recurrence.

show abstract

“…7 Even in the general population, iron-deficiency anemia and subsequent thrombocytosis are correlated with thrombotic events such as stroke. 8,9 Furthermore, exogenous administration of ESA increased platelet reactivity and platelet count in both healthy volunteers and patients with liver cirrhosis. [10][11][12] In addition, since most of the HD patients are resistant to ESA therapy due to iron deficiency, inflammation, and systemic illnesses (which are also major confounders to CVD risk), they frequently receive a higher dose of ESA therapy.…”

Section: Introductionmentioning

confidence: 97%

Regulation of platelet count by erythropoiesis-stimulating agents – iron axis in hemodialysis patients

Koike

Fukami

Kawaguchi

et al. 2016

IJNRD

View full text Add to dashboard Cite

Higher doses of erythropoiesis-stimulating agents (ESAs) contribute to atherothrombotic cardiovascular disease in hemodialysis (HD) patients. Thrombocytosis is associated with increased mortality in ESA-treated HD patients. We investigated variables affecting platelet count and its variability (platelet count increment [∆platelet count]) in HD patients. This retrospective longitudinal and observational study of HD outpatients was carried out over 3 years. The outcome was independent determinants of platelet count and ∆platelet count, which were associated with iron indices, ESA dose, and C-reactive protein. In univariate regression analysis, V-shaped relationship was observed between platelet count and transferrin saturation (TSAT), ferritin, serum iron, and hemoglobin (Hb) with the bottom of 0.21, 330 ng/mL, 49 µg/ dL, and 10.3 g/dL, respectively. Mixed-effect multivariate regression analysis revealed that TSAT (inversely), Hb #10.3 g/dL (inversely), C-reactive protein, and ESA dose were independently associated with platelet count. ∆platelet count was independently and inversely correlated with ∆TSAT and directly correlated with ∆ferritin. TSAT was independently and inversely associated with ESA dose. ESA dose was directly correlated with iron dose and inversely correlated with TSAT, ferritin #330 ng/mL, and Hb #10.3 g/dL. ESA dose and TSAT were correlated in determining platelet count and ∆platelet count. Targets of iron indices that reflect iron supply sufficient to avoid platelet count increment and variability may be .21% of TSAT and 300 ng/mL of serum ferritin for appropriate ESA therapy in HD patients.

show abstract

Carotid Artery Thrombus Associated With Severe Iron-Deficiency Anemia and Thrombocytosis

Abstract: Severe iron-deficiency anemia with thrombocytosis may be a risk factor for carotid artery thrombus formation. Medical management with anticoagulation and antiplatelet therapy is a reasonable approach for these patients while the thrombus resolves.

Cited by 125 publications

References 21 publications

Two Cases of Acute Ischemic Stroke Associated with Iron Deficiency Anemia due to Bleeding from Uterine Fibroids in Middle-aged Women

Two Cases of Acute Ischemic Stroke Associated with Iron Deficiency Anemia due to Bleeding from Uterine Fibroids in Middle-aged Women

Repeated Thrombus Formation Immediately Following Carotid Endarterectomy-Case Report-

Regulation of platelet count by erythropoiesis-stimulating agents – iron axis in hemodialysis patients

Contact Info

Product

Resources

About

Carotid Artery Thrombus Associated With Severe Iron-Deficiency Anemia and Thrombocytosis

Abstract: Severe iron-deficiency anemia with thrombocytosis may be a risk factor for carotid artery thrombus formation. Medical management with anticoagulation and antiplatelet therapy is a reasonable approach for these patients while the thrombus resolves.

Cited by 125 publications

References 21 publications

Two Cases of Acute Ischemic Stroke Associated with Iron Deficiency Anemia due to Bleeding from Uterine Fibroids in Middle-aged Women

Two Cases of Acute Ischemic Stroke Associated with Iron Deficiency Anemia due to Bleeding from Uterine Fibroids in Middle-aged Women

Repeated Thrombus Formation Immediately Following Carotid Endarterectomy-Case Report-

Regulation of platelet count by erythropoiesis-stimulating agents &ndash; iron axis in hemodialysis patients

Contact Info

Product

Resources

About

Regulation of platelet count by erythropoiesis-stimulating agents – iron axis in hemodialysis patients