Idiopathic thrombocytopenic purpura in childhood.
نویسندگان
چکیده
Purpura is a relatively common symptom in childhood and may be due to a variety of causes. A platelet count enables one to exclude the nonthrombocytopenic variety, but more elaborate investigations are needed to exclude other primary conditions which are often associated with thrombocytopenia, e.g. leukaemia. There remains a group of patients with idiopathic thrombocytopenic purpura and it is with this disease only that the present communication is concerned. In some cases spontaneous and permanent recovery occurs, but in others thrombocytopenia persists indefinitely, although the degree of bleeding varies from time to time. The self-limiting variety has been termed 'acute' and the persistent form 'chronic' (Hirsch and Dameshek, 1951). It should be emphasized, however, that the mode of onset may be acute in either variety and that spontaneous recovery may occur even after an illness lasting several months. At the onset it is not possible to classify cases precisely, and if death occurs early in the disease it will automatically be classified as 'acute', although not strictly self-limiting. The pathogenesis of neonatal purpura is probably different from that of idiopathic thrombocytopenic purpura; hence cases of neonatal purpura have not been included in this article. Purpura was originally described by Werlhof in 1775, but it was not until more than 100 years later that the association with thrombocytopenia was recognized (Osler, 1874; Krauss, 1883; Hayem, 1891). The possible role of the spleen in causation was suggested by Frank in 1915, and in the following year Kaznelson (1916) first suggested splenectomy as a method of treatment. As early as 1921 Bedson suggested that an auto-immune mechanism might be present, and this has been reconsidered recently (Evans and Duane, 1949; Harrington, Minnich,
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ورودعنوان ژورنال:
- Archives of disease in childhood
دوره 36 شماره
صفحات -
تاریخ انتشار 1961