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July 1978

Immune Thrombocytopenic Purpura in Perpetuity or The Malady Lingers On

Author Affiliations

Scripps Clinic and Research Foundation 10666 Torrey Pines Rd La Jolla, CA 92037

Arch Intern Med. 1978;138(7):1068. doi:10.1001/archinte.1978.03630320012007

In 1916 a medical student in Prague, Paul Kaznelson, became interested in the problem of thrombocytopenic purpura. He had encountered a patient with this disease, a woman of 36 years who for most of her life had bruised easily and had frequent nosebleeds and copious menstrual bleeding. She had a palpable spleen and a platelet count of 500/cu mm when, on the recommendation of young Kaznelson, Professor Doktor Schloffer performed a splenectomy and cured the purpura. Within four weeks the platelet count was 500,000/cu mm.1 Four years later the woman was in good health with a normal platelet count. She probably had what we now call immune thrombocytopenic purpura (ITP) and her recovery established splenectomy as an effective treatment for chronic ITP; 80% to 90% of patients with this variety of hypersplenism are cured thereby.

Kaznelson did more than this. Along with Ernst Frank he instigated one of the

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