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January 10, 1931


Author Affiliations

Lancaster, Pa.

JAMA. 1931;96(2):109-110. doi:10.1001/jama.1931.27220280002008a

Since Kaznelson, in 1916, performed the first splenectomy for purpura hemorrhagica there have been only 160 cases reported in the literature. It seems worth while to add another report to the series, especially as the duration of symptoms in this case is one of the longest on record.

The results of splenectomy have been brilliant in cases of purpura that are clear cut. Fortunately, all the cardinal signs were present: thrombocytopenia (highest count 10,000 after transfusion, usually none found); prolonged bleeding time (average, twenty minutes); nonretractile clot (none in twenty-four hours); positive capillary resistance test (showers of petechiae on the dependent parts even on merely standing), and a tendency to bleed from the mucous surfaces. It is interesting to note the rapid regeneration of blood when the acute hemorrhage was controlled. The dramatic change in the blood picture immediately after operation is noteworthy. The cessation of bleeding on clamping the