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June 1954

USE OF CORTISONE IN THROMBOCYTOPENIC PURPURAPreoperative and Postoperative Management of Patients

Author Affiliations

From the Departments of General Surgery and Hematology, Henry Ford Hospital.

AMA Arch Surg. 1954;68(6):787-793. doi:10.1001/archsurg.1954.01260050789008

OF THE many noted physiological effects of adrenocorticotropin (ACTH) and cortisone, perhaps their ability to produce variable degrees of remission in thrombocytopenic states may prove to be one of the most practicable. While splenectomy has been widely used in the treatment of idiopathic thrombocytopenic purpura for over 35 years, the results have not been entirely satisfactory. Welch and Dameshek1 reported that in a series of 92 patients splenectomized for idiopathic thrombocytopenic purpura, 61% showed complete and sustained therapeutic response and an additional 19% showed a partial response with a great reduction in the bleeding tendency. Most of the mortality associated with splenectomy for this condition has occurred in those instances when it became necessary to operate during an acute fulminating crisis. It is in these hazardous cases that sufficient search may not be made for accessory spleens and also where the splenic capsule may be torn and thus small

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