ABSTRACT NUMBER: ESOC2026A1033 STICKY PLATELET SYNDROME CAN CAUSE RECURRING TRANSIENT ISCHEMIC ATTACK: A CASE REPORT

Abstract Background and aims While ischemic stroke (IS) caused by sticky platelet syndrome syndrome (SPS) is rare, SPS was actually first described in a group of young-aged IS patients.1 We report a case of IS and recurring transient ischemic attack (TIA) caused by SPS to raise awareness of the effect of SPS to the cerebrovascular system. Methods A 57-year-old male came with slurred speech and right sided weakness. He had no history of hypertension and diabetes mellitus; was diagnosed with coronary artery disease a month before and currently taking antiplatelet and statin. The brain MRI showed hyperacute-acute infarction in left corona-radiata and basal-ganglia. The deficits lasted no more than 24 hours. MR, CT, and digital subtraction angiography were done with no remarkable result. The D-dimer, fibrinogen, protein C and S level were within normal limits. The peripheral blood smear demonstrated massive platelet clumping (Figure 1), while platelet antibody test was negative. The patient was discharged with additional acetyl-salicylic-acid (ASA) 80 mg. He then underwent less-than-24-hour right-sided weakness nine times, before benefiting from cilostazol 100 mg bid. The platelet clumping resolved, and the platelet aggregation test demonstrates hypoaggregation. Results Since there is no other significant risk factor, the unusual clumping condition of platelets suggests SPS as the cause of the recurrence TIA. Although low-dose ASA is reported to be effective to reverse hyperaggregability,2 the patient took better benefit from cilostazol. Conclusions While the diagnostic procedure of it is yet to be standardized, SPS should be considered as a risk factor for cryptogenic IS. Conflict of interest Anthonius Kurniadi: nothing to disclose. Linny Luciana: nothing to disclose. Figure 1 - belongs to Methods