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Can ITP Cause Plaque Build-Up

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2 months 5 days ago #74017 by Robert1959
Can ITP Cause Plaque Build-Up was created by Robert1959
I haven't posted for many years now as my ITP experience ended some 12 years ago.
A brief history before I get to my query.
I was a 54 year old male when I first developed ITP in January 2014 and ended up being a severe refractory patient.
I was given Prednisone, IVIG, Cyclosporine, Dapsone, Rituximab, Dexmethasone and Romiplostim (NPlate) before miraculously my platelet count returned to normal in December 2014. During this time my lowest count was 0 and on NPlate I did the roller coaster above the normal range and peaked at 1.2 million for a couple of weeks.
During this time and occasionally since when getting blood tests, I have had to get them redone in citrate as my platelets were clumped.
My query is, does anyone have any knowledge or experience if ITP can cause any plaque build-up in your arteries.
My GP suggested recently during my yearly health checks that I get a calcium score test done as my cholesterol levels have always been just above the standard range (ie 5.5 total with the 'good' reading normal and the 'bad' just above the normal range) but nothing of any real concern.
Anyway my calcium score was 1000 which is in the 90% bracket.
This was a total surprise and so I was sent to a cardiologist for further tests.
I did really well on the stress test treadmill and further blood tests were in the normal range however I had numerous plaque blockages, in particular around my heart.
I cannot understand the reason for this as I am a non-smoker, physically very active, had a good diet, have not had any chest pain or breathlessness and have no family history of heart disease.
I then had a coronary angiogram done with the hope of just having some stents however the situation was worse than expected and I am now scheduled to triple bypass at the end of March.
I had wondered if the treatments I was given could result on plaque build-up but Dr. Google said no (putting aside the very high platelet count when on NPlate).
I then thought I would check to see if ITP itself could result in plaque build-up and the response was that it could especially as the new platelets could be sticky and so I am wondering if ITP could be the culprit.
I apologise for this being a bit long-winded.
Regards Robert

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2 months 2 days ago - 2 months 2 days ago #74018 by Itpjourney
Replied by Itpjourney on topic Can ITP Cause Plaque Build-Up
I am very sorry you're going through this. This is big news, though!

This article says Platelet-to-Lymphocyte Ratio should be more like 106 than 141. Of course it could be much higher than 141. Mine goes higher cyclically, for sure. Since I have relatively low absolute lymphocytes. Good to know. Thank you for the heads up. I guess there's more to worry about... 

Maybe that's why Nplate says not to go over 200, I suppose depending on lymphocyte values. Who knew? Can we raise lymphocytes while we're at it?

pmc.ncbi.nlm.nih.gov/articles/PMC5336865/
The following user(s) said Thank You: Robert1959

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1 week 1 day ago #74031 by tyrionlannister
Replied by tyrionlannister on topic Can ITP Cause Plaque Build-Up
Robert, when your platelet count peaked at 1.2 million on NPlate, do you remember how long it stayed elevated before it was brought back down? I’m curious whether your cardiologist considered that period of extreme thrombocytosis as a possible contributor to the plaque burden or clotting risk later on.

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1 week 6 hours ago #74032 by Robert1959
Replied by Robert1959 on topic Can ITP Cause Plaque Build-Up
My count stayed at 1.2 million for 2 weeks and my haematologist told me to take 1/4 aspirin tablet to bring it down, which it did. Whilst I was on NPlate however and it finally started to have an effect, my platelet count did the roller coaster thing but I was generally still above the upper limit at around 600.
I mentioned this to both my cardio surgeon and my cardiologist but both didn't seem to think that it would have been a factor in my condition.
Interestingly, post-surgery my platelets were recorded as being at 114 on day 3 and 500 on day 6 which apparently is not unusual.
The bypass surgery went very well and apart from fatigue and getting my lungs to fully functional again, it wasn't that painful. I was on some pain killers whilst in ICU for 2 days and than some Panadol for the next 4 days while in the wards. I then went home and didn't require anything which was a pleasant surprise. Both the surgeon and cardiologist were very happy with my recovery at just 3 weeks post surgery even though it will still take many months to be fully recovered.

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