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Established 1972

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This Specia supported l Report is by Brought to you by the publisher

of

The Patho ph Thromboc ysiology of Immu ne ytopenic Purpura An Evolving Perspect November

ive

David Kuter,

MD, DPhil Associate Professor Harvard Medical Chief of Hematol School ogy Massach usetts General Hospital

“But there happen in is one Symptome proper and other Feavers the Loyns, peculiar to a pestilen the breast ; viz. Purple Specks Physitians and tial Feaver, name Peticule back, like unto , or Spots on the whol Body, which doth not commonly Flea-bitings or Petechi but especia named Purpura for the o; and blood boiling, lly in tae or Petechi these Feavers whichmost part; which do send the Italian ales, have forth it’s thinner Exhalat Purple or Spotted these Sympto ms, are Feavers... ions to the wherein surface of the the Skin.”

Introduction

This report was funded and written by Amgen by Bruce Inc. help of Buckley with the contribu ting report is for educatio faculty. This and not nal purpose intended s as a directive ommend ation on or recthe use of uct. The any prescrib ing physiciaprodsolely responsi n is sions relating ble for making all decicare, includin to appropriate patient g but not surgery, limited administ to ration tions, and any supporti of medicatain doses of medicati ve care. Cerin this docume ons discusse nt are reported d cal trials, review articles, in clinidocume or guideline nts. These doses may not be consiste or ing. Addition nt with product may labeluses does ally, discussion of those not imply Adminis Food and tration those indicatio (FDA) approva Drug l for ns.

from The

Practice

of Physick

, 1663

Lazarus Riverius Immune 1 acquired thrombocytopenic autoimm purpura (ITP) accepted thrombocytopeni une disorder is an as ITP results correct. One hypothe lating platelets a, a decreas characterized by ed number from excessiv sis was that platelets nose bleeding. It can lead to of circuby e destruct on the role the spleen, 3 and (epistaxis), symptoms such rhaging the other ion of as of impaired in localized megakaryocytes centered appear as skin or mucous hemorplatelet red or purple membranes duce platelets , the bone marrowproduction by bruising (purpura that spots . 5 An advance cells that molecula ). More rarely, (petechiae), and ated with prod r and severe bleeding it can be vided importan cellular physiolo understanding of from platelet associgy has since t insights destruction, events. ITP results gy of ITP, 3 creasing most recently into the pathoph proand that of thrombo ysioloin the disorderplatelet producti evidence is inthe discovery 2 on is also of lates the poietin (TPO), the often acute, . In children, impaired hormone the role production the onset and the condition that maps the without treatmen of ITP is key events of platelets. 6 This reguthe path t. 3 In adults, usually resolves in this history, article insidious of our growing in onset describin pathophysiology and chronic,ITP is frequently spontaneously. understanding g novel treatmen of ITP and affects women Among middle-a rarely resolving its implicati of the t strategie ons for adults, ITP female predomi more than men,ged s. 2 although nance is older than not evident the 60 Historical in patients Although years. 4 Perspective purpura Pathogenes antiquity, has been it was not is of ITP s on the known since 20th centurie until the late Purpura, were made s that significa 19th and early nt breakthr that yields termed after a nisms, 3 and in recognizing its gastropo a purple dye, underlyin oughs 2 seeming d mollusk a clinical g were put has mechaly been symptom opposing forth, both recognized as early as period by hypothe of which as were subsequ ses Galen, whophysicians such as the Greco-Roman ently Hippocra describe nences” or spots d the condition as tes and red “emiassociated with pestilent ial

2008

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