THE CONDITION first recorded by Werlhof1 and now known as "idiopathic," "essential," or "primary" thrombocytopenic purpura is usually described as a disease of unknown causation characterized by such hemorrhagic manifestations as purpura, bleeding from the mucous membranes, thrombocytopenia, a prolonged bleeding time, and failure of the clot to retract, in the absence of an underlying disease known to lead to thrombocytopenia.
In the many reviews published during the last 15 years the diagnostic features mentioned above have always been emphasized, together with the often dramatic results following splenectomy.2 On the other hand, the natural course of the disease has been discussed in relatively few publications,3 in spite of the fact that the tendency to remissions and relapses is well recognized. Although chronic mild hemorrhagic symptoms are mentioned, one usually gains the impression that while one attack of thrombocytopenic purpura leaves the patient subject to further attacks the
HIRSCH EO, DAMESHEK W. "IDIOPATHIC" THROMBOCYTOPENIA: Review of Eighty-Nine Cases with Particular Reference to the Differentiation and Treatment of Acute (Self-Limited) and Chronic Types. AMA Arch Intern Med. 1951;88(6):701–728. doi:10.1001/archinte.1951.03810120002001
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