IDIOPATHIC AND SECONDARY THROMBOCYTOPENIC PURPURA: CLINICAL STUDY AND EVALUATION OF 381 CASES OVER A PERIOD OF 28 YEARS

Abstract

This study presents an evaluation of the clinical and hematologic findigs in 381 patients with thrombocytopenic purpura. Of these patients, 271 were diagnosed as primary or idiopathic thrombocytopenic purpura (I.T.P.). The main points evaluated in this study are: a comparison of the results obtained with splenectomy versus corticosteroid therapy; the post-splenectomy life history of I.T.P. as a disease entity; the study of susceptibility to infections after splenectomy the evaluation of symptoms of lupus erythematosus after splenectomy, and to pin-point those underlying constitutional diseases in which thrombocytopenic purpura is most commonly encountered as a secondary hypersplenic complication. From our experience, we believe that splenectomy remains the treatment of choice in patients with primary or I.T.P., as well as in many selected patients with secondary thrombocytopenic purpura. Corticosteroid therapy should be reserved for children or young adults with thrombocytopenic purpura secondary to transitory viral or infectious diseases, patients with cardiac or other complications contraindicating surgery and patients failing to respond to spenectomy or having recurrence of their symptoms after splenectomy.