Werlhof in 1735 was the first to describe a symptom complex of hemorrhagic purpura. The essential type of this disease is sometimes referred to as Werlhof's disease.
Thrombocytopenic purpura is characterized by multiple hemorrhages into the skin and mucous membranes. One of the earliest indications of hemorrhage may be epistaxis, and the otolaryngologist may be the first to suspect the diagnosis and be instrumental in the institution of early treatment.
Thrombocytopenic purpura is characterized by prolonged bleeding time, poor clot retraction, an increase in capillary fragility, and a decrease in circulating platelets. It may be classified as (1) the essential, or primary, type and (2) the symptomatic, or secondary, type. In 1946 Dameshek and Miller suggested that the essential type was due to a splenic factor acting to prevent the formation of platelets. The symptomatic type was found with hypoplastic bone marrow. This may be due to a nutritional
NACHLAS NE. Thrombocytopenic Purpura Due to Quinidine. AMA Arch Otolaryngol. 1955;62(6):591–592. doi:10.1001/archotol.1955.03830060023006
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