Ischemic stroke in the setting of chronic immune thrombocytopenia in an elderly patient--a therapeutic dilemma Journal Article


Authors: De La Pena, A.; Fareed, J; Thethi, I.; Morales-Vidal, S.; Schneck, M. J.; Shafer, D.
Article Title: Ischemic stroke in the setting of chronic immune thrombocytopenia in an elderly patient--a therapeutic dilemma
Abstract: Chronic immune thrombocytopenia (ITP) carries a poor prognosis in the elderly patients. Increasing evidence proposes that a subgroup of patients with chronic ITP may be more susceptible to ischemic stroke. An 84-year-old Caucasian man with multiple ischemic stroke risk factors presented with acute onset of slurred speech, confusion, and unsteady gait. Physical examination and neurologic imaging were consistent with a new left thalamic infarct. Platelet counts ranged between 40 000 x 10(9)/L and 65 000 x 10(9) /L. Antiplatelet therapy for his newly acquired stroke was not initiated considering his low platelet counts and for mildly symptomatic thrombocytopenia, and the patient was discharged home. Both hematologic and neurologic guidelines for the management of chronic ITP and stroke have contradictory goals. Although anticoagulation is mandated in acute stroke, ITP causes low platelet counts that increase bleeding complications.
Journal Title: Clinical Applied Thrombosis/Hemostasis
Volume: 18
Issue: 3
ISSN: 1938-2723
Publisher: Unknown  
Journal Place: United States
Date Published: 2012
Start Page: 324
End Page: 326
Language: eng
DOI/URL:
Notes: JID: 9508125; 2011/11/14 [aheadofprint]; ppublish