[Accelerated atheroma with prednisone and clopidogrel].
BACKGROUND
Several mechanisms may explain the aggravation of atheroma lesions in patients receiving corticosteroid treatments.


METHODS
This 68-year-old man, a smoker with high cholesterol levels and a history of two transient ischemic attacks, also had severe Horton disease (giant cell arteritis) requiring treatment by corticosteroids and azathioprine. After a new transient ischemic accident, clopidogrel treatment was initiated. Ten months later, severe carotid stenosis was observed. Endarterectomy removed a recent thrombus and the pathology examination showed necrotic lesions complicated by hemorrhage with inflammatory infiltrate.


CONCLUSIONS
This patient's atheromatous disease was aggravated by intraplaque hemorrhage, caused by several factors include his corticosteroid therapy and platelet aggregation inhibition treatment.
Clinique Médicale, Hôpital d'Instruction des Armées du Val de Grâce, Paris. gildef@club-internet.fr
Gilles
G
Defuentes
Stéphane
S
Lecoules
Lionel
L
Vedrine
Gilles
G
Coutant
Bernard
B
Baranger
Jean-Pierre
JP
Algayres
D000368:Aged; D050197:Atherosclerosis / Q000139:chemically induced* / Q000473:pathology*; D016893:Carotid Stenosis / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D000077144:Clopidogrel; D004691:Endarterectomy; D013700:Giant Cell Arteritis / Q000188:drug therapy; D005938:Glucocorticoids / Q000009:adverse effects* / Q000627:therapeutic use; D006801:Humans; D007249:Inflammation; D008297:Male; D009336:Necrosis; D010975:Platelet Aggregation Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use; D011241:Prednisone / Q000009:adverse effects* / Q000627:therapeutic use; D013988:Ticlopidine / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use
D005938:Glucocorticoids; D010975:Platelet Aggregation Inhibitors; D000077144:Clopidogrel; D013988:Ticlopidine; D011241:Prednisone