Department of Internal Medicine, Hyogo Prefectural Tsukaguchi Hospital, 6-8-17 Minamitsukaguchi, Amagasaki, Hyogo, 661-0012, Japan.
J Thromb Thrombolysis. 2013 Jan;35(1):115-8. doi: 10.1007/s11239-012-0763-1.
Sometimes it is difficult to distinguish anti-phospholipid syndrome (APS) from immune thrombocytopenic purpura (ITP). Here we present successful management of ITP with anti-phospholipid antibodies, complicated by acute coronary syndrome (ACS), using CT coronary angiography (CTCA). The therapy for ITP may be changed for APS if ACS was thromboembolic event. As coronary angiography is thought to be very dangerous for patients with severe thrombocytopenia, noninvasive CTCA was desirable for our patient. Since no occlusion or narrowing was observed in CTCA, she has been safely treated as ITP with immunosuppressive agents throughout the course without antiplatelet or antithrombin therapy.
有时很难将抗磷脂综合征（APS）与免疫性血小板减少性紫癜（ITP）区分开来。在这里，我们介绍了一例使用 CT 冠状动脉造影（CTCA）成功治疗伴有急性冠状动脉综合征（ACS）的抗磷脂抗体相关 ITP。如果 ACS 是血栓栓塞事件，则 ITP 的治疗可能会因 APS 而改变。由于对于严重血小板减少的患者，冠状动脉造影被认为是非常危险的，因此对于我们的患者来说，非侵入性的 CTCA 是理想的选择。由于在 CTCA 中未观察到闭塞或狭窄，因此她一直安全地接受免疫抑制剂治疗作为 ITP，整个过程中没有使用抗血小板或抗凝治疗。
