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SPLENECTOMY IN THE TREATMENT OF HEMORRHAGIC PURPURA

SPLENECTOMY IN THE TREATMENT OF HEMORRHAGIC PURPURA Abstract Thrombocytopenic purpura hemorrhagica is characterized clinically by pathologic hemorrhage, ranging from a massive loss in the acute form, usually with a rapid termination, to the milder form, lasting for years. The blood platelets or thrombocytes show marked reduction. Until recently, splenectomy in the fulminating form was considered contraindicated and futile. Killins,1 Reuben and Claman2 and others, however, have reported recoveries from the acute form following splenectomy. The success of splenectomy in the majority of cases of the chronic form is conceded. A certain number of failures are reported, and these are difficult to explain. Giffin and Holloway3 found no clinical or hematologic improvement in 4 of their 28 cases. Spence,4 out of 101 cases abstracted, found 15 per cent with a return of symptoms. The commonly accepted theory for the successful results after splenectomy regards the spleen as abnormally destructive to platelets, producing thrombocytopenia and its References 1. Killins, W. A.: Acute Thrombocytopenic Purpura Cured by Splenectomy , J. A. M. A. 92:1832 ( (June 1) ) 1929.Crossref 2. Reuben, M. D., and Claman, L.: Splenectomy in Acute Thrombocytopenic Purpura Hemorrhagica , Arch. Pediat. 45:84 ( (Feb.) ) 1928. 3. Giffin, H. Z., and Holloway, J. K.: A Review of Twenty-Eight Cases of Purpura Hemorrhagica in Which Splenectomy Was Performed , Am. J. M. Sc. 170:186 ( (Aug.) ) 1925.Crossref 4. Spence, A. W.: Results of Splenectomy for Purpura Hemorrhagica , Brit. J. Surg. 15:466 ( (Jan.) ) 1928.Crossref 5. Morrison, M. D.; Lederer, M., and Fradkin, W. Z.: Accessory Spleens, Their Significance in Essential Thrombocytopenic Purpuric Hemorrhagica , Am. J. M. Sc. 176:672 ( (Nov.) ) 1928.Crossref 6. Glanzman, E.: Hereditäre hämorrhagische Thrombasthenie , Jahrb. f. Kinderh. 88:1 and 113, 1918. 7. Rothman, P. E., and Nixon, N. K.: Familial Purpura Hemorrhagica Without Thrombopenia , J. A. M. A. 93:16 ( (July 6) ) 1929. 8. Minot, G. R.: A Familial Hemorrhagic Condition Associated with Prolongation of the Bleeding Time , Am. J. M. Sc. 175:301 ( (March) ) 1928.Crossref 9. Giffin, H. Z.: Unusual Types of Hemorrhagic Disease , Am. J. M. Sc. 175:44 ( (Jan.) ) 1928.Crossref 10. Sweeney, J. S.: Chronic Aplastic Anemia and Symptomatic Purpura Hemorrhagica Probably Due to Benzol Poisoning , Am. J. M. Sc. 175:317 ( (March) ) 1928.Crossref 11. Kennedy, R. L. J.: Diseases of Children Benefited by Splenectomy , J. A. M. A. 91:874 ( (Sept. 22) ) 1928.Crossref 12. Little, W. D., and Ayres, W. W.: Hemorrhagic Diseases , J. A. M. A 91:1251 ( (Oct. 27) ) 1928.Crossref 13. Brill, N. E., and Rosenthal, N.: Treatment by Splenectomy of Essential Thrombocytopenia (Purpura Hemorrhagica) , Arch. Int. Med. 32:939 ( (Dec.) ) 1923Crossref 14. The Curative Treatment by Splenectomy of Chronic Thrombocytopenic Purpura Hemorrhagica , Am. J. M. Sc. 166:503 ( (Oct.) ) 1923.Crossref 15. Kaznelson: Wien. klin. Wchnschr. 29:1451, 1916. 16. Evans, W. H.: The Blood Changes After Splenectomy in Splenic Anemia, Purpura Hemorrhagica and Acholuric Jaundice, with Special Reference to Platelets and Coagulation , J. Path. & Bact. 31:815 ( (Oct.) ) 1928. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Surgery American Medical Association

SPLENECTOMY IN THE TREATMENT OF HEMORRHAGIC PURPURA

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References (17)

Publisher
American Medical Association
Copyright
Copyright © 1933 American Medical Association. All Rights Reserved.
ISSN
0004-0010
eISSN
1538-3644
DOI
10.1001/archsurg.1933.01170010106009
Publisher site
See Article on Publisher Site

Abstract

Abstract Thrombocytopenic purpura hemorrhagica is characterized clinically by pathologic hemorrhage, ranging from a massive loss in the acute form, usually with a rapid termination, to the milder form, lasting for years. The blood platelets or thrombocytes show marked reduction. Until recently, splenectomy in the fulminating form was considered contraindicated and futile. Killins,1 Reuben and Claman2 and others, however, have reported recoveries from the acute form following splenectomy. The success of splenectomy in the majority of cases of the chronic form is conceded. A certain number of failures are reported, and these are difficult to explain. Giffin and Holloway3 found no clinical or hematologic improvement in 4 of their 28 cases. Spence,4 out of 101 cases abstracted, found 15 per cent with a return of symptoms. The commonly accepted theory for the successful results after splenectomy regards the spleen as abnormally destructive to platelets, producing thrombocytopenia and its References 1. Killins, W. A.: Acute Thrombocytopenic Purpura Cured by Splenectomy , J. A. M. A. 92:1832 ( (June 1) ) 1929.Crossref 2. Reuben, M. D., and Claman, L.: Splenectomy in Acute Thrombocytopenic Purpura Hemorrhagica , Arch. Pediat. 45:84 ( (Feb.) ) 1928. 3. Giffin, H. Z., and Holloway, J. K.: A Review of Twenty-Eight Cases of Purpura Hemorrhagica in Which Splenectomy Was Performed , Am. J. M. Sc. 170:186 ( (Aug.) ) 1925.Crossref 4. Spence, A. W.: Results of Splenectomy for Purpura Hemorrhagica , Brit. J. Surg. 15:466 ( (Jan.) ) 1928.Crossref 5. Morrison, M. D.; Lederer, M., and Fradkin, W. Z.: Accessory Spleens, Their Significance in Essential Thrombocytopenic Purpuric Hemorrhagica , Am. J. M. Sc. 176:672 ( (Nov.) ) 1928.Crossref 6. Glanzman, E.: Hereditäre hämorrhagische Thrombasthenie , Jahrb. f. Kinderh. 88:1 and 113, 1918. 7. Rothman, P. E., and Nixon, N. K.: Familial Purpura Hemorrhagica Without Thrombopenia , J. A. M. A. 93:16 ( (July 6) ) 1929. 8. Minot, G. R.: A Familial Hemorrhagic Condition Associated with Prolongation of the Bleeding Time , Am. J. M. Sc. 175:301 ( (March) ) 1928.Crossref 9. Giffin, H. Z.: Unusual Types of Hemorrhagic Disease , Am. J. M. Sc. 175:44 ( (Jan.) ) 1928.Crossref 10. Sweeney, J. S.: Chronic Aplastic Anemia and Symptomatic Purpura Hemorrhagica Probably Due to Benzol Poisoning , Am. J. M. Sc. 175:317 ( (March) ) 1928.Crossref 11. Kennedy, R. L. J.: Diseases of Children Benefited by Splenectomy , J. A. M. A. 91:874 ( (Sept. 22) ) 1928.Crossref 12. Little, W. D., and Ayres, W. W.: Hemorrhagic Diseases , J. A. M. A 91:1251 ( (Oct. 27) ) 1928.Crossref 13. Brill, N. E., and Rosenthal, N.: Treatment by Splenectomy of Essential Thrombocytopenia (Purpura Hemorrhagica) , Arch. Int. Med. 32:939 ( (Dec.) ) 1923Crossref 14. The Curative Treatment by Splenectomy of Chronic Thrombocytopenic Purpura Hemorrhagica , Am. J. M. Sc. 166:503 ( (Oct.) ) 1923.Crossref 15. Kaznelson: Wien. klin. Wchnschr. 29:1451, 1916. 16. Evans, W. H.: The Blood Changes After Splenectomy in Splenic Anemia, Purpura Hemorrhagica and Acholuric Jaundice, with Special Reference to Platelets and Coagulation , J. Path. & Bact. 31:815 ( (Oct.) ) 1928.

Journal

Archives of Surgery – American Medical Association

Published: Jan 1, 1933

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