Hypertension is the main risk factor for both white matter lesions (WMLs) and stroke, but many stroke patients do not have WMLs. To find specific determinants of WMLs, the authors assessed 321 ischemic and hemorrhagic stroke patients who had undergone echocardiography. The patients with WMLs (n=160) were more often hypertensive and had a higher systolic blood pressure than the patients without WMLs. However, in a multivariate analysis, only the following variables remained associated with WMLs: (1) age: odds ratio [OR], 1.08 per year (95% confidence interval [CI], 1.06-1.11); (2) left ventricular relative wall thickness (RWT) ≥0.52: OR, 2.78 (95% CI, 1.59-4.88); (3) lacunar strokes: OR, 4.15 (95% CI, 1.83-9.44); (4) hemorrhagic strokes: OR, 5.36 (95% CI, 1.57-18.39); and (5) female: OR, 1.91 (95% CI, 1.12-3.27). Thus, the main modifiable risk factor for WMLs was RWT, which proved to be an even stronger risk factor than hypertension. This suggests that RWT might be a useful target in the treatment of hypertension to counteract the appearance of WMLs.

Objective: To describe a case of likely etoricoxib-induced severe thrombocytopenia. Clinical Presentation and Intervention: A 32-year-old woman was referred to our hospital for disseminated petechial rash after 7 days of therapy with etoricoxib. At admission, the patient’s platelet count was 3,000/mm³. At Naranjo’s scale correlation between thrombocytopenia and drug was considered as “probable.” With the diagnostic tests performed we did not find other causes of thrombocytopenia. Etoricoxib was discontinued. The patient was treated with intravenous immunoglobulin and corticosteroids with a complete resolution of the thrombocytopenia in a few days. Conclusion: The prevalence of thrombocytopenia induced by etoricoxib should be studied as it may not be very rare.

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