Korean J Med.  2011 Aug;81(2):251-256.

A Case of Pulmonary Thromboembolism in a Patient with Idiopathic Thrombocytopenic Purpura

• Kim SK
• Kang JY
• Choi SH
• Hong YA
• Kim JS
• Kim SW
• Song JS

Abstract

Idiopathic thrombocytopenic purpura (ITP) is an autoimmune blood disorder characterized by thrombocytopenia. Common clinical manifestations include bleeding events. Rarely, thrombotic complications may develop in ITP. A 43-year-old man was admitted with dyspnea. His platelet count at admission was 48,000/mm3. The patient had a history of ITP diagnosed 12 years earlier and had been treated with low-dose steroids. Two months before admission, he had been diagnosed with deep vein thrombosis and treated only with clopidogrel due to severe thrombocytopenia. Chest computed tomography showed filling defects in both pulmonary arteries. In the workup for precipitating factors, only lupus anticoagulant was positive. The concomitant administration of warfarin and methylprednisolone was used to treat the pulmonary thromboembolism and ITP, respectively. Six months later, the lupus anticoagulant test remained positive. The patient was confirmed to have a pulmonary thromboembolism due to antiphospholipid syndrome, which might be related to the underlying ITP. After 10 months, his symptoms and radiological findings had improved.

Keyword

Antiphospholipid syndrome; Lupus coagulation inhibitor; Pulmonary embolism; Purpura thrombocytopenic idiopathic

MeSH Terms

Adult
Antiphospholipid Syndrome
Dyspnea
Hemorrhage
Humans
Lupus Coagulation Inhibitor
Methylprednisolone
Platelet Count
Precipitating Factors
Pulmonary Artery
Pulmonary Embolism
Purpura, Thrombocytopenic, Idiopathic
Steroids
Thorax
Thrombocytopenia
Ticlopidine
Venous Thrombosis
Warfarin
Lupus Coagulation Inhibitor
Methylprednisolone
Steroids
Ticlopidine
Warfarin