title: [Recurrent thromboembolism due to increased acetylsalicylic acid-resistant platelet aggregation].
abstract: A 49-year-old man had for 30 years suffered from severe recurrent thromboembolism with leg-vein thrombosis, pulmonary emboli, mesenteric infarction, cerebrovascular accident, cerebral vein thrombosis, portal vein thrombosis and femoral artery occlusion requiring leg amputation. In addition to moderately increased clotting activation with single-fold positive demonstration of fibrin monomers and a D-dimer concentration of 1 mg/l platelet aggregation was increased and could not be influenced by aspirin, 300 mg daily. Despite aspirin there were recurrent transitory attacks of cerebral ischaemia. Fibrin monomers were threefold positive and D-dimer concentration was increased to 4 mg/l (elevated clotting activation). Ticlopidine administration (250 mg daily) reduced adenosine diphosphate-induced platelet aggregation by 30% without effect on collagen-induced platelet aggregation. In parallel to these changes the patient's general condition clearly improved: fibrin monomers were no longer demonstrated and the D-dimer level fell to 0.5 mg/l.
authors.affiliation: Medizinische Klinik und Poliklinik, Klinikum Rudolf Virchow, Standort Charlottenburg, Freien Universität Berlin.
authors.forename: G
authors.initials: G
authors.lastname: Himmelreich
authors.forename: H
authors.initials: H
authors.lastname: Riess
mesh_terms: D001241:Aspirin / Q000494:pharmacology*; D005337:Fibrin / Q000032:analysis; D006801:Humans; D008297:Male; D008875:Middle Aged; D010974:Platelet Aggregation / Q000187:drug effects*; D012008:Recurrence; D013923:Thromboembolism / Q000097:blood* / Q000188:drug therapy; D013988:Ticlopidine / Q000494:pharmacology / Q000627:therapeutic use
chemical_list: D005337:Fibrin; D013988:Ticlopidine; D001241:Aspirin
vernacular_title: Rezidivierende Thromboembolien infolge gesteigerter, gegen Acetylsalicylsäure resistenter Thrombozytenaggregation.