title: Elevated platelet microparticle levels after acute ischemic stroke with concurrent idiopathic thrombocytopenic purpura.
abstract: We report a 60-year-old woman with idiopathic thrombocytopenic purpura who experienced acute infarction of the middle cerebral artery. She was treated with an antiplatelet agent and prednisolone to limit platelet activation and destruction. In parallel with clinical amelioration, levels of plasma platelet microparticles (PMPs), a procoagulant factor in platelet activation, decreased after treatment but increased after reduction of the prednisolone dose, resulting in progression of vascular stenosis. Immunosuppressive therapy with cyclosporine normalized plasma PMP levels, and no additional vascular events occurred during the 3-month follow-up period. Immunosuppressive therapy to decrease plasma PMP levels is warranted after acute ischemic stroke in the context of idiopathic thrombocytopenic purpura.
authors.affiliation: Department of Neurology and Neurological Science, Tokyo Medical and Dental University, Tokyo, Japan.
authors.forename: Masahiko
authors.initials: M
authors.lastname: Ichijo
authors.affiliation: Department of Neurology and Neurological Science, Tokyo Medical and Dental University, Tokyo, Japan.
authors.forename: Satoru
authors.initials: S
authors.lastname: Ishibashi
authors.affiliation: Department of Neurology and Neurological Science, Tokyo Medical and Dental University, Tokyo, Japan.
authors.forename: Takuya
authors.initials: T
authors.lastname: Ohkubo
authors.affiliation: First Department of Internal Medicine, Kansai Medical University, Osaka, Japan.
authors.forename: Shosaku
authors.initials: S
authors.lastname: Nomura
authors.affiliation: Department of Neurology and Neurological Science, Tokyo Medical and Dental University, Tokyo, Japan.
authors.forename: Nobuo
authors.initials: N
authors.lastname: Sanjo
authors.affiliation: Department of Neurology and Neurological Science, Tokyo Medical and Dental University, Tokyo, Japan.
authors.forename: Takanori
authors.initials: T
authors.lastname: Yokota
authors.affiliation: Department of Neurology and Neurological Science, Tokyo Medical and Dental University, Tokyo, Japan. Electronic address: h-mizusawa.nuro@tmd.ac.jp.
authors.forename: Hidehiro
authors.initials: H
authors.lastname: Mizusawa
mesh_terms: D001792:Blood Platelets / Q000187:drug effects / Q000473:pathology*; D055252:Cell-Derived Microparticles / Q000187:drug effects* / Q000473:pathology; D002533:Cerebral Angiography / Q000379:methods; D000077407:Cilostazol; D016572:Cyclosporine / Q000627:therapeutic use; D003907:Dexamethasone / Q000627:therapeutic use; D038524:Diffusion Magnetic Resonance Imaging; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D020244:Infarction, Middle Cerebral Artery / Q000097:blood / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D018810:Magnetic Resonance Angiography; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D011239:Prednisolone / Q000627:therapeutic use; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000097:blood / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D013777:Tetrazoles / Q000627:therapeutic use; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D015854:Up-Regulation
chemical_list: D005938:Glucocorticoids; D007166:Immunosuppressive Agents; D010975:Platelet Aggregation Inhibitors; D013777:Tetrazoles; D003907:Dexamethasone; D016572:Cyclosporine; D011239:Prednisolone; D000077407:Cilostazol
keywords: Idiopathic thrombocytopenic purpura; ischemic stroke; platelet microparticles