Thrombopenic Purpura

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IN 1932 Lowenburg and Ginsburg1 first reported an apparent beneficial result following the accidental administration of parathyroid hormone to a young patient with essential thrombocytopenic purpura. The dosage was sufficient to cause severe hypercalcemia and clinical signs of toxic overdosage. Again in 1936 these authors2 obtained a similar clinical response following the subcutaneous administration of 60 units of parathyroid hormone daily for four consecutive days. Both patients had failed to respond to other measures such as transfusions and antivenin injections. In neither patient had splenectomy been performed prior to the administration of parathyroid extract.

Parathyroid hormone has been used at the Cleveland Clinic since 1940 as one of the methods of treatment in patients with thrombopenic purpura. This report concerns the first patient treated at the Clinic by the induction of hypercalcemia with parathyroid hormone. The patient reported here had failed to respond to all the usual methods of therapy including splenectomy.

Case Report

A 26-year-old housewife was admitted to the Cleveland Clinic Hospital on July 14, 1940, with complaints of excessive menstrual bleeding, profuse epistaxis, and bruising easily with slight injury. In February, 1940 she first noticed “black and blue” spots under the skin and several weeks later menorrhagia persisting for ten to fourteen days. In May, 1940 she developed prolonged and recurrent nasal and gingival bleeding which remained uncontrolled despite local measures of treatment.

The past history and family history contributed nothing pertinent. The menstrual cycles were normal prior to her present illness and she had never been. . .



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