Lagrue G, Antelin C, Kabaker M
Arch Mal Coeur Vaiss. 1986 Jun;79(6):792-5.
Primary thrombocythemia may cause vascular thrombosis; it has been rarely involved in coronary atherosclerosis with myocardial infarction. We report three cases of renal arteries atherosclerosis occurring in association with primary thrombocythemia. These cases are three young women (20, 40 and 42 years old) with severe hypertension secondary to atherosclerosis with stenosis of renal arteries, one or both sided, and in association in one case with diffuse arterial stenosis. Systematic investigation revealed thrombocytosis with latent myeloproliferative syndrome of megacaryocytic colony. Thrombocytosis was previously present as attested by a blood count one year before (in one case) and by long-term peripheral vasomotor troubles, electively improved by aspirin (in two cases). In none of these three cases, vascular risk factors, nor hereditary vascular diseases were present. So we assume that platelets high levels are responsible for this early atherosclerosis, in keeping with the well-know role of platelets in atherosclerosis pathogenesis. Platelets investigations must be done in case of renovascular hypertension, occurring without any classical vascular risk factors.
原发性血小板增多症可能导致血管血栓形成；它很少与伴有心肌梗死的冠状动脉粥样硬化相关。我们报告3例与原发性血小板增多症相关的肾动脉粥样硬化病例。这些病例为3名年轻女性（20岁、40岁和42岁），因肾动脉粥样硬化伴狭窄（单侧或双侧）继发严重高血压，其中1例还伴有弥漫性动脉狭窄。系统检查发现血小板增多，并伴有潜在的巨核细胞集落骨髓增殖综合征。血小板增多症先前即已存在，1年前的血常规检查（1例）以及长期外周血管舒缩功能障碍（2例服用阿司匹林后有明显改善）均可证实。这3例均无血管危险因素或遗传性血管疾病。因此，我们认为高水平血小板是导致这种早期动脉粥样硬化的原因，这与血小板在动脉粥样硬化发病机制中所起的众所周知的作用相符。对于无任何典型血管危险因素而发生肾血管性高血压的病例，必须进行血小板检查。
