Laboratory findings, responses to medication, and results of surgery were studied in 24 children and 26 adults with idiopathic thrombocytopenic purpura (ITP). Splenectomy was never performed as an emergency measure in this series; the medical treatment with steroids and platelet transfusions in every instance changed the emergency situation into one permitting more deliberate measures. Splenectomy was performed on 23 patients, 16 of whom were receiving steroids. In the other 27 patients no surgery was done; 24 improved with medical treatment and 2 had spontaneous remissions. These patients, frequently children, had acute cases predominantly. The follow-up data available from 47 patients showed that 42 were in complete remission when last seen. There was one death. Seven case histories illustrate the need for individualizing the treatment.
Scharfman WB, Hosley HF, Hawkins T, Propp S. IDIOPATHIC THROMBOCYTOPENIC PURPURAAN EVALUATION OF THE PATTERNS OF RESPONSE TO VARIOUS THERAPIES. JAMA. 1960;172(17):1875–1884. doi:10.1001/jama.1960.03020170001001