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Article
June 1917

DIMINISHED BLOOD PLATELETS AND MARROW INSUFFICIENCY: A CLASSIFICATION AND DIFFERENTIAL DIAGNOSIS OF PURPURA HEMORRHAGICA, APLASTIC ANEMIA, AND ALLIED CONDITIONS

Author Affiliations

BOSTON

From the Medical Service of the Massachusetts General Hospital.

Arch Intern Med (Chic). 1917;XIX(6):1062-1084. doi:10.1001/archinte.1917.00080260105009
Abstract

The two conditions, idiopathic purpura hemorrhagica and aplastic anemia, present the common symptoms, anemia and purpura. In text-book descriptions of purpura hemorrhagica and aplastic anemia there is usually no mention of a differential diagnosis between these conditions, though Naegeli1 does briefly consider the differences, and Frank,2 in a comprehensive paper, discusses these types of cases. Naegeli1 and Pratt3 confirm my own belief derived from clinical discussions, from the study of cases, reports and text-book descriptions, that these conditions are not infrequently confused with each other. Not only are these two conditions confused with each other, but also with the nonleukemic phase of leukemia, bone marrow tumors, osteosclerosis, and, at times, with pernicious anemia and types of splenic anemia, etc. Purpura hemorrhagica is sometimes confused with the other types of purpura, and the chronic type is often undoubtedly confused with hemophilia. This confusion

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