title: [Antiplatelet therapy can unmask an inherited bleeding disorder. Aspirin-like defect of platelets does not protect against atherosclerosis].
abstract: Some inherited platelet disorders may be revealed late, as in the presented case of a 68-year-old-man. Recurrent epistaxis following peri-interventional antiplatelet therapy (after three elective percutaneous coronary interventions) and an episode of upper gastrointestinal haemorrhage required aspirin withdrawal and less frequent clopidogrel use. Platelet studies showed an aspirin-like defect resulting in a lack of arachidonate-induced platelet aggregation. During dose-reduced (2-3 times a week) clopidogrel administration ADP-induced platelet aggregation was effectively inhibited and neither important bleeding nor stent thrombosis occurred. The inherited defect of cyclooxygenase-1, responsible for platelet thromboxane synthesis, did not protect the patient against coronary and extra-cardiac atherosclerosis.
authors.affiliation: Oddział Chorób Wewnetrznych Szpitala Miejskiego ZOZ Poznań-Nowe Miasto, ul. Szwajcarska 3, 61-285 Poznań, Poland. welikowski@wp.pl
authors.forename: Waldemar
authors.initials: W
authors.lastname: Elikowski
authors.forename: Ewelina
authors.initials: E
authors.lastname: Hanszke
authors.forename: Wiesława
authors.initials: W
authors.lastname: Biczysko
authors.forename: Janusz
authors.initials: J
authors.lastname: Rzeźniczak
authors.forename: Aleksandra
authors.initials: A
authors.lastname: Kruk-Zagajewska
authors.forename: Krystyna
authors.initials: K
authors.lastname: Zawilska
mesh_terms: D000368:Aged; D001241:Aspirin / Q000009:adverse effects*; D001791:Blood Platelet Disorders / Q000175:diagnosis* / Q000201:enzymology*; D003324:Coronary Artery Disease / Q000517:prevention & control; D051545:Cyclooxygenase 1 / Q000187:drug effects; D006801:Humans; D008297:Male; D010974:Platelet Aggregation / Q000187:drug effects; D010975:Platelet Aggregation Inhibitors / Q000009:adverse effects*; D013931:Thromboxanes / Q000096:biosynthesis
chemical_list: D010975:Platelet Aggregation Inhibitors; D013931:Thromboxanes; D051545:Cyclooxygenase 1; D001241:Aspirin