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Akuter thrombembolischer ST-Hebungs-Infarkt bei einem Patienten mit essenzieller Thrombozytose

Acute thrombo-embolic elevated ST infarct in a patient with essential thrombocytosis

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Zusammenfassung

Ein 48-jähriger Patient wird mit plötzlich aufgetretenen thorakalen Beschwerden sowie einer Thrombozytose notfallmäßig aufgenommen. In der Koronarangiographie zeigte sich ein Verschluss der rechten Herzkranzarterie durch thrombotisches Material, der erfolgreich mittels PTCA, Stenting und intrakoronarer Abciximabgabe versorgt werden konnte. Postinterventionell erhielt der Patient nach Stentimplantation eine erhöhte Thrombozytenaggregationshemmung mit Acetylsalicylsäure (ASS) und Clopidogrel aufgrund inadäquaten Ansprechens auf die duale antithrombozytäre Therapie. Aufgrund des thrombembolischen Ereignisses bei einer Thrombozytenzahl über 1 Mio./µl wurde eine zytoreduktive Therapie mit Hydroxyharnstoff begonnen.

Abstract

A 48-year-old man presented with acute chest pain and a greatly increased platelet count. Emergency coronary angiographc revealed thrombotic occlusion of the right coronary artery. Coronary angioplasty and stenting were successfully combined with intracoronary abciximab administration. Due to inadequate postinterventional platelet inhibition an intensified dual antiplatelet therapy with acetylsalicylic acid (ASS) and clopidogrel was applied to prevent stent thrombosis. Due to the thrombo-embolic complication and a platelet count over 1 million/µl a cytoreductive treatment with hydroxyurea was initiated.

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Danksagung

Ganz herzlicher Dank gilt Herrn Dr. W. Bethge von der Abteilung für Hämatologie und Onkologie des Universitätsklinikums Tübingen für die Durchsicht des Manuskripts und für wertvolle Anregungen und Ergänzungen.

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Authors and Affiliations

  1. Medizinische Klinik III, Universitätsklinikum Tübingen, Otfried-Müller-Str. 10, 72076, Tübingen, Deutschland

    C. Doesch, A.E. May, G. Toncar-Pflumm, N. Anders, T. Geisler & M. Gawaz

  2. Institut für Pathologie, Universitätsklinikum Tübingen, Tübingen, Deutschland

    S. Kröber & R. Kandolf

Authors
  1. C. Doesch
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  2. A.E. May
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  3. G. Toncar-Pflumm
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  4. N. Anders
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  5. T. Geisler
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  6. S. Kröber
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  7. R. Kandolf
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  8. M. Gawaz
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Corresponding author

Correspondence to C. Doesch.

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Doesch, C., May, A., Toncar-Pflumm, G. et al. Akuter thrombembolischer ST-Hebungs-Infarkt bei einem Patienten mit essenzieller Thrombozytose. Internist 48, 1282–1289 (2007). https://doi.org/10.1007/s00108-007-1942-6

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  • DOI: https://doi.org/10.1007/s00108-007-1942-6

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