Chronic platelet activation and progressive vascular dementia in patients with immune thrombocytopenic purpura (ITP)

In ITP, autoantibody binds to antigens on platelets and can activate or imp air platelet functions. We report clinical laboratory and radiologic data o n 14 ITP patients who developed vascular dementias in the course of chronic ITP. Platelet activation was evident in all with high PMP and overexpressi on of p-selectin. In spite of severe thrombocytopenias, they were remarkabl y free from bleeding but paradoxically suffered from TIA-Iike syndromes fro m ischemic small-vessel disease df brain shown by CAT scan or MRI. The epis odes of TIA became more frequent and cognitive dysfunctions gradually progr essed to vascular dementias. Prior and during dementia, platelets were high er and ITP was often in remission, Activated platelets with high PMP may ca use vasculopathy and thrombosis. Chronic platelet activation may lead to va scular dementias.