Deep Vein Thrombosis in Patients with Idiopathic Thrombocytopenic purpura

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  • SUGIYAMA Hiroyuki
    The Second Department of Internal Medicine, Faculty of Medicine, Kyoto University
  • SHIMADA Hideto
    The Second Department of Internal Medicine, Faculty of Medicine, Kyoto University
  • YAGITA Masato
    The Second Department of Internal Medicine, Faculty of Medicine, Kyoto University
  • HORIUCHI Tetsuro
    The Second Department of Internal Medicine, Faculty of Medicine, Kyoto University
  • TAKAHASHI Takayuki
    The Second Department of Internal Medicine, Faculty of Medicine, Kyoto University
  • HOSHINO Takashi
    The Second Department of Internal Medicine, Faculty of Medicine, Kyoto University
  • KUMADA Kaoru
    The Second Department of Surgery, Faculty of Medicine, Kyoto University

Bibliographic Information

Other Title
  • 経過中に深部静脈血栓症を併発した（特発性）血小板減少性紫斑病の2例
  • ケイカチュウ ニ シンブ ジョウミャク ケッセンショウ オ ヘイハツシタ トク
  • —Report of two cases—

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Abstract

The report deals with 2 cases of rare complication of deep vein thrombosis occurred during course of idiopathic thrombocytopenic purpura (ITP). Case 1, a 33-year-old man, entered our hospital because of bleeding tendency and anemia. Laboratory examinations disclosed RBC 2.33×106/cmm, PLT 28×103/cmm, positive direct Coombs'test, positive anti-platelet IgG antibody and both erythroid and megakaryocytic hyperplasia of the bone marrow. Under a diagnosis of Evans'syndrome he was treated with corticosteroid without significant. effect. Yet, a month later he developed a deep vein thrombosis in the left lower extremity, and further 2 months later he had an another episode of thrombosis in the right lower extremity. Case 2, a 63-year old man, has been continuously given corticosteroid since 5 years ago, when a diagnosis of ITP was made with positive anti-platelet antibody. He developed deep vein thrombosis in the left lower extremity following a mild contusion on the left leg when his platelet count was 13,000/cmm.<br>Possible pathogenesis of such deep vein thrombosis is discussed as follows:<br>1) preparatory aggregation of platelet due to presence of large amount of immunocomplexes in the circulation and on the platelet surface<br>2) hypercoagulability due to steroid therapy<br>3) an increase in the vascular platelet reserved pool<br>4) traumatic or other pathogenetic micro-hemorrhage in the vascular wall of large vein with subsequent thrombosis.

Journal

  • Rinsho Ketsueki

    Rinsho Ketsueki 23 (3), 365-370, 1982

    The Japanese Society of Hematology

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