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Splenectomy for Chronic Idiopathic Thrombocytopenic Purpura
Ralph C. Wilde, MD;
Lawrence D. Ellis, MD;
William M. Cooper, MD
AMA Arch Surg. 1967;95(3):344-350.
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THERE has been some controversy regarding the proper management of chronic idiopathic thrombocytopenic purpura (ITP) since 1950.1 During this period, the treatment of choice has made a complete cycle. Initially, splenectomy was the only modality of treatment which produced a reasonable percentage of lasting remissions. Because of low remission rates in the 50% to 60% range, and because of the rather high mortality and morbidity of the procedure, the medical profession wished to find a more effective method of treatment. The discovery of the therapeutic benefits of corticosteroids in autoimmune disorders provided a possible solution. For several years steroids enjoyed popularity as the treatment of choice, and splenectomy was reserved only for those patients in whom long-term medical management failed. Unfortunately, prolonged remission rates with steroids were no higher than 35% to 50%.2 In addition, the undesirable complications of long-term steroid therapy, namely, acne, osteoporosis, peptic ulceration, moon
. . . [Full Text PDF of this Article]
Author Affiliations
Pittsburgh
From the University of Pittsburgh School of Medicine.
Footnotes
Submitted for publication March 30, 1967.
Read before the 24th annual meeting of the Central Surgical Association, Pittsburgh, Feb 23, 1967.
Reprint requests to 3500 Fifth Ave, Pittsburgh 15213 (Dr. Wilde).
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