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December 8, 1997

Myocardial Ischemia in a Patient With Chronic Refractory Idiopathic Thrombocytopenic Purpura

Author Affiliations

Columbus, Ohio

Arch Intern Med. 1997;157(22):2668. doi:10.1001/archinte.1997.00440430150028

The importance of platelets in the development of ischemic coronary syndromes has been documented in animal models. The use of antiplatelet agents in coronary artery disease is well established. Theoretically, qualitative and quantitative depression of platelet function should prevent the development of arterial occlusion. Myocardial ischemia occurring with chronic idiopathic thrombocytopenia has been rarely documented.1-3 We describe a patient with non—Q-wave myocardial infarction (MI) and chronic refractory idiopathic thrombocytopenic purpura (ITP).

Report of a Case.  A 52-year-old premenopausal woman presented to our institution with new-onset unstable angina. Her medical history included chronic refractory ITP diagnosed at age 39 years and treated by splenectomy, prednisone, danazol, and intermittent intravenous immunoglobulin. After age 39 years, our patient also suffered from diabetes mellitus, hypertension, and hepatitis C. She was a nonsmoker and not taking aspirin. Her blood pressure was 180/100 mm Hg, and pulse, 90 bpm. The results of a physical examination were

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