A RARE CASE OF ARTERIOSCLEROSIS OBLITERANS WITHOUT PROMINENT RISK-FACTORS COMPLICATED BY IDIOPATHIC THROMBOCYTOPENIC PURPURA - A CASE-REPORT

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.