Management of myocardial infarction in immune thrombocytopenic purpura with anti-phospholipid antibodies.
Sometimes it is difficult to distinguish anti-phospholipid syndrome (APS) from immune thrombocytopenic purpura (ITP). Here we present successful management of ITP with anti-phospholipid antibodies, complicated by acute coronary syndrome (ACS), using CT coronary angiography (CTCA). The therapy for ITP may be changed for APS if ACS was thromboembolic event. As coronary angiography is thought to be very dangerous for patients with severe thrombocytopenia, noninvasive CTCA was desirable for our patient. Since no occlusion or narrowing was observed in CTCA, she has been safely treated as ITP with immunosuppressive agents throughout the course without antiplatelet or antithrombin therapy.
Department of Internal Medicine, Hyogo Prefectural Tsukaguchi Hospital, 6-8-17 Minamitsukaguchi, Amagasaki, Hyogo, 661-0012, Japan. rtabata@hp.pref.hyogo.jp
Rie
R
Tabata
Chiharu
C
Tabata
Yoshio
Y
Kita
D054058:Acute Coronary Syndrome / Q000150:complications / Q000000981:diagnostic imaging / Q000188:drug therapy*; D000368:Aged; D017152:Antibodies, Antiphospholipid; D017023:Coronary Angiography; D005260:Female; D005343:Fibrinolytic Agents / Q000008:administration & dosage*; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage*; D009203:Myocardial Infarction / Q000150:complications / Q000000981:diagnostic imaging / Q000188:drug therapy*; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage*; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000150:complications / Q000000981:diagnostic imaging / Q000188:drug therapy*; D015898:Tomography Scanners, X-Ray Computed
D017152:Antibodies, Antiphospholipid; D005343:Fibrinolytic Agents; D007166:Immunosuppressive Agents; D010975:Platelet Aggregation Inhibitors