Aortic dissection in a young man with immune thrombocytopenic purpura

A 36-year-old man who presented with epigastric and back pain was subsequently diagnosed with aortic dissection. Our patient lacked classic risk factors that would have predisposed him to develop this condition at a young age. He did, however, suffer from untreated, chronic immune thrombocytopenic purpura (ITP) and had a platelet count less than 20,000/mm3 on admission. We postulate that the thrombocytopenia led to spontaneous hemorrhage within the vasa vasorum of the aorta and the subsequent development of aortic dissection. Chronic ITP has been associated with an increased risk of intracranial hemorrhage but, to our knowledge, has not been reported to be associated with aortic dissection. We encourage clinicians to be aware of this potential risk factor for aortic dissection.