The course of idiopathic thrombocytopenic purpura (ITP) was studied in four groups of patients. In the first group of 24 patients the therapy did not include either steroids or splenectomy, but 10 had complete remissions within a year after the ITP was recognized. All 10 were less than 10 years of age and each had had an infection within a month before the onset of the ITP. The second group consisted of 16 patients who received steroids without splenectomy; the third consisted of 26 who did not receive steroids but underwent splenectomy. The fourth group, consisting of 19 patients, were treated both with steroids and by splenectomy. Complete remissions were obtained in 25 (81%) of the splenectomized patients and only 1 1 (38%) of the patients treated with steroids. Splenectomy gave better results than did steroids in the dosages used, but there were three serious postoperative infections, and in one case lupus erythematosus appeared 12 months after the splenectomy.
Carpenter AF, Wintrobe MM, Fuller EA, Haut A, Cartwright GE. TREATMENT OF IDIOPATHIC THROMBOCYTOPENIC PURPURA. JAMA. 1959;171(14):1911–1916. doi:10.1001/jama.1959.03010320001001
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