Which platelet disorders produce neurologic disease?
- Primary acute or chronic immune thrombocytopenia purpura (ITP),
- disseminated intravascular coagulation (DIC),
- thrombotic thrombocytopenic purpura (TTP),
- dysimmune thrombocytopenia (DIT) secondary to rheumatic disease (associated with anticardiolipin antibodies) or hyperviscosity states,
- heparin-associated thrombocytopenia (HAT) all are associated with neurologic disease due to thrombocytopenic states.
TTP produces a microangiopathic hemolytic anemia with prominent neurologic symptoms of headache, encephalopathy, or seizures, whereas DIC and (less commonly) ITP may produce larger intracerebral hemorrhages.
HAT and DIT more commonly cause ischemic strokes.
Thrombocytosis usually results from essential thrombocythemia, which produces symptoms of a hyperviscosity state when platelet counts exceed 600,000 to 1,000,000 per microliter.
Cerebrovascular complications—TIAs and ischemic stroke—are the serious consequences of this disease.
