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Published 4 June 2009
Cite this as: BMJ Case Reports 2009 [doi:10.1136/bcr.04.2009.1748]
Copyright © 2009 by the BMJ Publishing Group Ltd.

Rare disease

Cerebral infarction in idiopathic thrombocytopenic purpura: a case report

Karim Mahawish, Nicholas Pocock, Sujeeth Mangarai, Anil Sharma

Department of Medicine for the Elderly, Aintree University Hospital, Lower Lane, Liverpool L9 7AL, UK

Correspondence to:
Karim Mahawish, k.mahawish{at}nhs.net

SUMMARY

Cerebral infarction is a rare but recognised complication of idiopathic thrombocytopenic purpura. With traditional therapies including antiplatelets precluded in such patients and little guidance in the literature, the optimal treatment strategy is unknown. This report describes a case of ischaemic stroke in a patient with idiopathic thrombocytopenic purpura and deteriorating neurology. A successful outcome was made possible using a sequential approach initially improving platelet levels with steroids and intravenous immunoglobulin and then commencing antiplatelet agents. A possible mechanism for thrombosis in idiopathic thrombocytopenic purpura is considered.


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