IDIOPATHIC THROMBOCYOTPENIC PURPURA, WITH SPECIAL REFERENCE TO HYPERSPLENISM.:I. CLINICAL OBSERVATIONS

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Three serious cases of idiopathic thrombopenic purpura, all adult females, were observed. They all had hemorrhagic tendency, as from subcutaneous and mucous bleedings to profuse menorrhagia and recurrent intracranial bleedings.The definite diagnosis was established by proving the depletion of platelet count in blood smear, the absence of demonstrable cause of the disease, hyperplastic marrow with increased number of megakaryocytes and limited platelet formation in the marrow.The fact that each case revealed pronounced anemia, leucopenia with lymphocytosis, and thrombopenia, maintained marrow function and positive epinephrin test is quite a support to the theory which regards this condition as the manifestaion of hypersplenism.The failure of the treatment with conservative procedures, resulting in two deaths, indicates early splenectomy
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