Introduction: Several mechanisms may explain the aggravation of atheroma lesions in patients receiving corticosteroid treatments.
Case: This 68-year-old man, a smoker with high cholesterol levels and a history of two transient ischemic attacks, also had severe Horton disease (giant cell arteritis) requiring treatment by corticosteroids and azathioprine. After a new transient ischemic accident, clopidogrel treatment was initiated. Ten months later, severe carotid stenosis was observed. Endarterectomy removed a recent thrombus and the pathology examination showed necrotic lesions complicated by hemorrhage with inflammatory infiltrate.
Discussions: This patient's atheromatous disease was aggravated by intraplaque hemorrhage, caused by several factors include his corticosteroid therapy and platelet aggregation inhibition treatment.