Ischaemic Stroke in a Patient With Refractory Idiopathic Thrombocytopenic Purpura: An Unusual Clinical Dilemma

Abstract

Idiopathic Thrombocytopenic Purpura (ITP) is commonly associated with bleeding complications, and thrombotic events are very rare. We report a patient with long standing ITP refractory to treatment who developed a large cerebral infarct. The patient's management was complicated by other co-morbidities, a bleeding tendency and recurrent cerebral ischaemia. A careful approach to treatment, based on the understanding of the patho-physiological mechanism of the patient's stroke, his co-morbidity and the estimated risk of haemorrhagic complications was required in this case.

Recurrent Cerebral Infarctions and Multi-Vessel Thrombosis in a Male Patient with Refractory Idiopathic Thrombocytopenic Purpura: a Case Report

“…Previously reported cases of ITP combined with thrombosis were present more in females and patients with accompanying autoimmune diseases [ 4 5 6 ]. On the contrary, cases of male patients with both ITP and thrombosis were found in few reports [ 1 9 10 11 12 ]. Rhee et al [ 1 ] reported a 33-year-old male patient with recurrent ischemic strokes resulting from ITP.…”

Vertebral Artery Thrombosis in Chronic Idiopathic Thrombocytopenic Purpura

“…In two of them, antiplatelet therapy was given and there were no hemorrhagic events [4, 7]. On the other hand, antiplatelet therapy was withheld in three cases without any further adverse thrombotic events [5, 8, 10]. Other treatments such as calcium channel blockers were given in two cases.…”