Anticoagulant therapy in chronic idiopathic thrombocytopenic purpura.

By RIai iiD J. COHEN, LEWIS H. DENNIS AND MARCEL E. CONRAD T HE PARENTERAL ADMINISTRATION of small doses of heparin to normal adults1 and to patients with arteriosclerotic heart disease2 has no measurable effect on blood platelet economy. However, larger amounts of heparin1 and therapeutic doses of bishydroxycoumarin ( Dicumarol) distinctly prolong tile survival of circulating platelets.3’4 The latter findings led us to investigate the effect of anticoagulant therapy upon the platelet count in a patient with severe chronic idiopathic thrombocytopenic purpura who was unresponsive to splenectomy, corticosteroids and immunosuppressive drug therapy. Specific coagulation factor assays and studies of fibrinolysis were performed to ascertain if accelerated intravascular coagulation played a role in the etiology of the thrombocytopenia.