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[An infantile case of cerebral infarction associated with thrombocytosis]
T Tamura1, K Konno, S Matsumoto
1Department of Pediatrics, Southern Touhoku Hospital, Fukushima.
Insights
This study reports a rare case of infantile cerebral infarction linked to thrombocytosis. The infant recovered with rehabilitation and aspirin, suggesting potential links between iron deficiency anemia and thrombocytosis.
Area of Science:
- Pediatric Neurology
- Hematology
Background:
- Cerebral infarction in children typically stems from vascular disorders, cardiac issues, head trauma, or infections.
- Blood disorders are an uncommon cause of pediatric cerebral infarction.
Observation:
- An eight-month-old female infant presented with left hemiparesis following minor head trauma.
- Imaging revealed cerebral infarction in the right internal capsule and corona radiata.
- Laboratory results showed iron-deficiency anemia and significant thrombocytosis (platelet count 107.5 x 10(4)/mm3).
Findings:
- Despite no apparent cause for iron deficiency, serum iron was low (18 micrograms/dl).
- Bone marrow examination showed a slight increase in megakaryocytes but was otherwise normal.
- Anemia resolved with oral iron, but thrombocytosis persisted.
- Neurological deficits gradually improved with rehabilitation, and no recurrence was noted after aspirin treatment.
Implications:
- This case highlights a rare association between infantile cerebral infarction and thrombocytosis.
- The underlying cause of thrombocytosis remains unclear, with secondary thrombocytosis due to iron deficiency anemia or essential thrombocytosis being postulated.
- Further research is needed to elucidate the mechanisms linking these conditions in pediatric patients.
Abstract:
Cerebral infarction in children is often caused by intracranial vascular disorder, cardiac disease, head injury, or infection, and is rarely induced by blood disease. In this paper, we describe an infantile case of cerebral infarction associated with thrombocytosis. A female infant of eight months of age developed left hemiparesis after a slight head injury. Her CT and MRI demonstrated a cerebral infarction located from the right internal capsule to the right corona radiata. Laboratory findings revealed iron-deficiency anemia and thrombocytosis with a platelet count 107.5 x 10(4)/mm3. Although she had no disorder that had caused iron deficiency, serum Fe value of the patient was low with a count of 18 micrograms/dl. Her bone marrow was normal except for a slight increase in the number of megakaryocytes. One month later, her anemia was improved by means of oral iron replacement. However, her platelet count remained at more than 100 x 10(4)/mm3 as it had been before. Her condition of left-sided hemiparesis gradually improved by a program of rehabilitation, and did not recur after aspirin administration. Although the main cause of her thrombocytosis that led to a transient cerebrovascular accident is obscure, it is postulated that her iron deficiency anemia induced secondary thrombocytosis, or else the patient had essential thrombocytosis.