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首页> 外文期刊>Journal of stroke and cerebrovascular diseases: The official journal of National Stroke Association >A Case of Multiple Cerebral Infarction Preceding Acute Exacerbation of Idiopathic Thrombocytopenic Purpura
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A Case of Multiple Cerebral Infarction Preceding Acute Exacerbation of Idiopathic Thrombocytopenic Purpura

机译：特发性血小板减少紫癜急性加剧前脑梗死的案例

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Background: Although it was suggested that idiopathic thromobocytopenic purpura (ITP) can be a paradoxical cause of cerebral infarction, previous reports indicate that cerebral infarction associated with ITP occurs when thrombocytopenia is already evident at the onset of cerebral infarction. Case report: We report a case of multiple cerebral infarction that preceded acute exacerbation of ITP. An 80-year-old woman with a history of ITP presented with tetraplegia, and brain magnetic resonance imaging revealed multiple infarction in bilateral cerebral and cerebellar hemispheres. For ITP, she was treated with oral prednisolone and subcutaneous injection of thrombopoietin receptor agonists. Her platelet count was within the normal range at the onset of cerebral infarction. Medical work-up did not reveal the obvious causes of her multiple cerebral infarction. On day 10 of hospitalization, she showed melena and oral hemorrhage and her platelet count markedly decreased. Her platelet-associated IgG level was elevated and a diagnosis of acute exacerbation of ITP was made. She was treated with intravenous immunoglobulin and her platelet count increased moderately. However, her neurological symptoms and cerebral infarction on magnetic resonance imaging deteriorated accompanied by hemorrhagic transformation. Finally, she died of respiratory failure. Conclusions: Our case suggests that thrombophilia accompanied by ITP can precede actual exacerbation of ITP and we have to consider ITP as a possible cause of multiple cerebral infarction, even when the platelet count is within the normal range at the onset of cerebral infarction.
机译：背景：虽然有人建议特发性血激黄卵细胞发作性（ITP）可以是脑梗死的矛盾原因，但之前的报道表明，当血小板减少在脑梗死的发作时发生血小板减少症时，发生与ITP相关的脑梗死。案例报告：我们报告了对ITP的急性加剧的多种脑梗死的情况。一名80岁的女性，具有Tetraplegia的ITP历史，脑磁共振成像显示双侧脑和小脑半球的多种梗塞。对于ITP，她受到口服泼尼松的治疗和皮下注射血小板生成素受体激动剂。她的血小板计数是脑梗死发作的正常范围内。医疗工作未揭示她多种脑梗死的明显原因。在住院的第10天，她表现出Melena和口腔出血，她的血小板计数明显减少。她的血小板相关的IgG水平升高，并进行了对ITP的急性加剧的诊断。她被静脉内免疫球蛋白治疗，她的血小板计数适度增加。然而，她的神经症状和脑梗塞在磁共振成像上伴随过出血性转化。最后，她死于呼吸衰竭。结论：我们的案例表明，即使血小板计数在脑梗死的正常范围内，我们必须将ITP视为多种脑梗死的可能原因，伴随ITP伴随的血栓激素可以在实际加剧。

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