Mahawish Karim, Pocock Nicholas, Mangarai Sujeeth, Sharma Anil
Department of Medicine for the Elderly, Aintree University Hospital, Lower Lane, Liverpool L9 7AL, UK.
BMJ Case Rep. 2009;2009. doi: 10.1136/bcr.04.2009.1748. Epub 2009 Jun 4.
Cerebral infarction is a rare but recognised complication of idiopathic thrombocytopenic purpura. With traditional therapies including antiplatelets precluded in such patients and little guidance in the literature, the optimal treatment strategy is unknown. This report describes a case of ischaemic stroke in a patient with idiopathic thrombocytopenic purpura and deteriorating neurology. A successful outcome was made possible using a sequential approach initially improving platelet levels with steroids and intravenous immunoglobulin and then commencing antiplatelet agents. A possible mechanism for thrombosis in idiopathic thrombocytopenic purpura is considered.
脑梗死是特发性血小板减少性紫癜一种罕见但已被认知的并发症。由于此类患者不能使用包括抗血小板药物在内的传统疗法，且文献中指导较少，最佳治疗策略尚不清楚。本报告描述了一例患有特发性血小板减少性紫癜且神经功能不断恶化的缺血性脑卒中患者。采用序贯治疗方法取得了成功，即先用类固醇和静脉注射免疫球蛋白提高血小板水平，然后开始使用抗血小板药物。文中还考虑了特发性血小板减少性紫癜中血栓形成的可能机制。
