An Elderly Case of Idiopathic Thrombocytopenic Purpura Associated with Acute Myocardial Infarction.

DOI PubMed 1 Citations 12 References
  • Araki Tsutomu
    Department of Internal Medicine, Saiseikai Kanazawa Hospital
  • Tofuku Yohei
    Department of Internal Medicine, Saiseikai Kanazawa Hospital

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  • 急性心筋梗塞を合併した特発性血小板減少性紫斑病の１高齢者例

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Abstract

We report a rare case of idiopathic thrombocytopenic purpura (ITP) associated with acute myocardial infarction (AMI). A 72-year-old woman with hypertension and hemorrhoids was admitted because of chest pain, severe anemia (RBC 340×104/μl, Hb 5.4g/dl, Ht 21.7%) and thrombocytopenia (0.2×104/μl). AMI was diagnosed by electrocardiogram (ST elevation and negative T in V2-5), echocardiogram (hypokinesis in anteroseptal wall) and laboratory (CPK 470U/l) findings and was treated with only blood transfusion. Chest pain disappeared the day after admission, and neither heart failure nor arrhythmia occurred. Based on bone marrow findings (hyperplasia of erythroblast and megakaryocyte), endoscopic (internal hemorrhoids) and laboratory (antiplatelet antibody positive, platelet associatedIgG 257.8ng/107 cells) findings, iron deficiency anemia and ITP were diagnosed. Anemia improved after blood transfusion, but thrombocytopenia (<1.0×104/μl) without active bleeding continued after steroid and γ-globulin therapy. At discharge, electrocardiogram showed a negative T in I, aVL and V2-5, and Tl and BMIPP myocardial scintigram showed defects in the anteroseptal and apical wall.

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