S. Yamagishi et al., A RARE CASE OF ARTERIOSCLEROSIS OBLITERANS WITHOUT PROMINENT RISK-FACTORS COMPLICATED BY IDIOPATHIC THROMBOCYTOPENIC PURPURA - A CASE-REPORT, Angiology, 47(4), 1996, pp. 413-417
An eighty-four-year-old man was admitted to the hospital because of pa
in at rest in the lower extremities. On physical examination, trophic
changes of the skin and petechiae in the limbs were observed. Computed
tomographic scan of the abdomen showed focal renal infarctions and ca
lcification of the descending aorta. Moreover, radionuclide imaging of
the arterial system revealed complete obstructions of the two right i
liac arteries and the left external iliac artery, where collateral flo
ws were observed. Laboratory examination showed a severe thrombocytope
nia caused by immunoglobulin G (IgG)-type autoantibody against platele
ts. He was diagnosed as having arteriosclerosis obliterans complicated
by idiopathic thrombocytopenic purpura, although no known risk factor
s promoting atherosclerosis other than age were evident. In such a cas
e with hemorrhagic diathesis, a hemorheologic agent and the vasodilato
r prostaglandin could confer advantages in relieving and controlling t
he ischemic leg pain without hemorrhagic complications. Moreover, smal
l doses of the initial predonisolone therapy for ITP might also be rec
ommended to avoid thrombus formations in the atherosclerotic lesions.