Splenic macrophages in thrombocytopenia.

S ALTZSTEIN,’ AND LANDING ET AL,2 in 1961 described the occurrence of lipid laden histiocytes in spleens examined in patients with idiopathic thrombocytopenic purpura following splenectomy. These workers suggested that these changes were due to an accumulation of lipids following the ingestion of platelets by the splenic reticuloendothelial system. Similar interpretations have been made by Hill et al, ( 1963 ) . In this study splenic tissue has been obtained following splenectomy in patients with a number of disorders and examined under the electron microscope. In the majority of patients with idiopathic thrombocytopenic purpura, but not in other instances, platelets have been seen within splenic histiocytes in various stages of digestion. The end result is the production of myelin figures and lipid droplets. These findings support the previous contention that the splenic lipidosis seen in idiopathic thrombocytopenic purpura is a direct result of platelet phagocytosis.