The Management of Thrombocytopenic States with Particular Reference to Platelet Thromboplastic Function. I. Idiopathic and Secondary Thrombocytopenic Purpura

Bonnin, J. A.

doi:10.1111/j.1365-2141.1961.tb00333.x

Cited by 16 publications

(3 citation statements)

References 7 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…It has been shown that corticotrophin does not interfere with growth to the same extent as exogenous steroids while at the same time controlling the underlying disease [17,18]. In rare cases of ITP that were refractory to Prednisone, some observers have recorded success with ACTH [6]. But, since it has to be given parentcrally, thus involving the risk of local haemorrhage, we feel that ACTH should be avoided.…”

Section: Commentmentioning

confidence: 99%

Management of Chronic Idiopathic Thrombocytopenic Purpura in Children, with Particular Reference to Immunosuppressive Therapy

Lo¹,

Hitzig²,

Sigg³

1969

Acta Haematol

View full text Add to dashboard Cite

Section: Commentmentioning

confidence: 99%

Management of Chronic Idiopathic Thrombocytopenic Purpura in Children, with Particular Reference to Immunosuppressive Therapy

Lo¹,

Hitzig²,

Sigg³

1969

Acta Haematol

View full text Add to dashboard Cite

“…Bonnin 43 demonstrated the benefit of steroids in ITP as early as 1950. Recent radiolabelling studies indicate that increased platelet counts are produced by increasing platelet production rather than by blocking antibody production or decreasing platelet clearance.…”

Section: Steroidsmentioning

confidence: 98%

Immune thrombocytopenia in pregnancy

Browning¹,

James²

1990

Fet. Matern. Med. Rev.

View full text Add to dashboard Cite

Autoimmune thrombocytopenia (ITP)1) The risks to mother and fetus have previously been overstated.2) There is no maternal test which will accurately determine fetal thrombocytopenia.3) The only reliable test for fetal thrombocytopenia is cordocentesis – this carries a higher morbidity than that of fetal intracerebral haemorrhage from ITP.4) Contrary to received wisdom, there is no evidence that, even for the most severely thrombocytopenic infant, abdominal delivery protects against intracranial haemorrhage.5) Management therefore involves keeping the maternal platelet count above 50 × 1091 and choosing the route of delivery on normal obstetric grounds.Alloimmune thrombocytopenia1) Alloimmune thrombocytopenia is commoner than hitherto believed (0.15% all neonates).2) The fetal risks are considerable: intracranial haemorrhage occurs in 4% of cases antenatally and in 10% in labour. The risks are virtually confined to those with a platelet count of less than 30 × 109l−1.3) Cordocentesis is justified for the ‘at risk’ fetus; fetal immunoglobulin or platelet therapy can be given.4) When the fetal platelet count is below 50 × 109l−1, abdominal delivery should be planned.5) A maternal screening test for neonatal alloimmune thrombocytopenia exists (lack of P1A1 antigen).

show abstract

“…More objectively Vigliano and Horowitz (9) have recently given good evidence in a patient suffering from multiple myeloma with moderate thrombocytopenia [a disease in which Bonnin (8) found an impaired PTF] that the prolonged bleeding time and poor in vivo adhesion of platelets resulted from coating of collagen by the abnormal protein.…”

Section: Plateletsmentioning

confidence: 99%

Hemostasis and Homeostasis

Roskam¹

1967

Thromb Haemost

View full text Add to dashboard Cite

IV. General Conclusions and Summary1. Normal hemostasis depends on the combined participation of 3 sorts of hemostatic factors: vascular (including its participation in local hemodynamics), platelet and blood clotting factors, the level of which when it can be assessed largely exceeds the requirements of the organism.2. Disordered hemostasis usually results from combined moderate deficiencies of at least 2 of these factors, i.e. from an “immediate” multi-causation.3. The mechanisms of homeostasis keeping hemostatic factors production at a suitable level are still unknown.4. Inversely we have a fairly good knowledge of the mechanisms neutralizing or removing from the blood stream activated blood clotting factors and hemostatic compounds released by platelets.5. When the latter mechanisms are defective and when concomitantly, blood clotting factors and platelets are sufficiently activated and/or endothelium is widely damaged, then disseminated intravascular coagulation occurs, which may lead to deficiencies of at least 2 hemostatic factors, and hence to a more or less severe bleeding tendency.6. Thus, just as such acute or subacute hemorrhagic syndromes complicating consumption coagulopathies are based upon an “immediate” multi-causation consisting of several defective hemostatic factors, they depend on a “remote” multi-causation with respect to the origin of these joint deficiencies.7. Between both of these multi-causations, immediate and remote, there is a single pathway : an important, continuous and sufficiently rapid thrombin formation.8. This explains why the best treatment of acute and subacute hemorrhagic disorders complicating disseminated intravascular coagulation is the administration of heparin.Spaet’s and our own views are only a beginning. Most of the problems concerning relations between hemostasis and homeostasis are still unsolved, for instance nature and origin of the vascular factor impeding the arrest of bleeding in idiopathic thrombocytopenic purpura, the pathogenesis of several chronic hemorrhagic conditions associated with disseminated vascular coagulation, the influence of the nervous system, catamenia, pregnancy, etc. on various hemorrhagic syndromes, etc., to say nothing of the effects of muscular exercise on von Willebrand’s disease. They deserve systematically conducted research work.

show abstract

The Management of Thrombocytopenic States with Particular Reference to Platelet Thromboplastic Function. I. Idiopathic and Secondary Thrombocytopenic Purpura

Cited by 16 publications

References 7 publications

Management of Chronic Idiopathic Thrombocytopenic Purpura in Children, with Particular Reference to Immunosuppressive Therapy

Management of Chronic Idiopathic Thrombocytopenic Purpura in Children, with Particular Reference to Immunosuppressive Therapy

Immune thrombocytopenia in pregnancy

Hemostasis and Homeostasis

Contact Info

Product

Resources

About