Platelet-mediated thrombotic complications in patients with ET: Reversal by aspirin, platelet reduction, and not by coumadin

Blood Cells, Molecules & Diseases
J J MichielsHuub H D M van Vliet

Abstract

The broad spectrum of aspirin-sensitive erythromelalgia, its microvascular ischemic complications, migraine-like atypical or typical transient ischemic attacks (cerebral and ocular) as well as acute coronary syndromes in thrombocythemia vera (essential thrombocythemia and thrombocythemia associated with polycythemia vera in maintained remission by phlebotomy) is caused by platelet cyclo-oxygenase-mediated arteriolar inflammation, fibromuscular intimal proliferation without and with occlusive thrombosis by platelet-rich thrombi in the end-arterial microvasculature of the peripheral, cerebral, ocular and coronary circulation. These microvascular ischemic and thrombotic complications does not respond to Coumadin, but are immediately relieved by a loading dose of 500 mg aspirin, and does not recur when the patient is maintained on low dose aspirin (50 mg per day) or after reduction of platelet counts to normal (<400.000/microl).

References

Aug 1, 1991·American Heart Journal·M G SchefferJ R Roelandt
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Jul 1, 1984·Histopathology·J J MichielsJ Abels
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Jan 9, 2004·The New England Journal of Medicine·Raffaele LandolfiUNKNOWN European Collaboration on Low-Dose Aspirin in Polycythemia Vera Investigators

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Citations

Dec 31, 2015·Current Opinion in Hematology·Daniel Aruch, John Mascarenhas
Jul 10, 2007·Journal of the American College of Surgeons·Ralph G DePalmaLeo R Zacharski
Nov 9, 2010·Dermatologic Therapy·Gionata BuggianiTorello Lotti
Mar 28, 2006·Blood Cells, Molecules & Diseases·Petro E Petrides, Fabian Siegel
May 6, 2019·Expert Opinion on Emerging Drugs·Lucia Masarova, Srdan Verstovsek
Nov 25, 2006·Hematology·Tiziano Barbui, Guido Finazzi
Feb 1, 2007·Blood·Guido Finazzi, Tiziano Barbui

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