Immune Thrombocytopenia historical perspective

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Maryam Barkhordarian, M.D.[2]

Idiopathic Thrombocytopenia (ITP) was first described by a German poet Paul Werlhof, in 1735. He referred to classical signs of ITP as mucosal bleeding, black and purple spots on the patient's arm, due to this description, ITP is called Werlhof's disease.In 1881, an Italian pathologist, Guilio Bizzozero was the first to discover the role of platelet in hemostasis. In 1889, George Hayem proved the association between purpura and the development of thrombocytopenia by physically counting the patient's platelet. In 1916, a medical student Paul Kasnelson developed the idea of excessive destruction of platelets by spleen. Soon he persuaded his professor Schloffer to splectomize a patient with ITP, thereafter they found outstanding increase of platelet count following splenectomy. In 1951, Harrington experiment in Missouri proved the hypothesis that a humoral factor causes platelet destruction. He exchanged whole blood of himself and a patient with chronic purpura who had the same blood group. after the exchange, the patient platelet count remained unchanged but his platelet count which was normal prior to exchange dropped to 10 x 109 /L . In 1951, an American hematologist, Maxwell Wintrobe, showed immunosuppressive therapy with corticosteroids. In 1981, Paul Imbach in Switzerland, realized the role of Fc receptors on splenic macrophages led to first successful use of intravascular immunoglobulin. In 2009, International working group (IWG) recommended standard terminology for ITP. The term " purpura" was removed from immune thrombocytopenia as many patients don't have cutaneous bleeding but ITP as shorthand for immune thrombocytopenia was redefined by IWG.

• Idiopathic Thrombocytopenia (ITP) was first described by a German poet Paul Werlhof, in 1735. He referred to classical signs of ITP as mucosal bleeding, black and purple spots on the patient’s arm, due to this description, ITP is called Werlhof’s disease.
• In 1881, an Italian pathologist, Guilio Bizzozero was the first to discover the role of platelet in hemostasis.
• In 1889, George Hayem proved the association between purpura and the development of thrombocytopenia by physically counting the patient’s platelet.
• In 1916, a medical student Paul Kasnelson developed the idea of excessive destruction of platelets by spleen. Soon he persuaded his professor Schloffer to splectomize a patient with ITP, thereafter they found outstanding increase of platelet count following splenectomy.
• In 1951, Harrington experiment in Missouri proved the hypothesis that a humoral factor causes platelet destruction. He exchanged whole blood of himself and a patient with chronic purpura who had the same blood group. after the exchange, the patient platelet count remained unchanged but his platelet count which was normal prior to exchange dropped to 10 x 10⁹ /L .
• in 1951, an American hematologist, Maxwell Wintrobe, showed immunosuppressive therapy with corticosteroids.
• In 1981, Paul Imbach in Switzerland, realized the role of Fc receptors on splenic macrophages led to first successful use of intravascular immunoglobulin. ^[1]
• In 2009, International working group (IWG) recommended standard terminology for ITP. The term ” purpura” was removed from immune thrombocytopenia as many patients don’t have cutaneous bleeding but ITP as shorthand for immune thrombocytopenia was redefined by IWG. ^[2]

The following are a few famous cases of [disease name]:

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