Platelet Immunology in Idiopathic Thrombocytopenic Purpura: A Review and Experimental Study

Albert Matthew Ross



Within the past decade, progress in immuno-hematology has extended beyond the study of the erythrocyte. The demonstration of antibodies to red cells in some cases of acquired hemolytic anemia and in erythroblastosis fetalis defined the hypothetical existence of analogous phenomena for leucocytes and platelets. Advancements in immunologic technique have elevated the importance of immune bodies in the etiology of several cytopenic blood dis orders. Extensive research has been done to elucidate the presence and nature of an anti-platelet factor in the serum of patients with thrombocytopenic purpura. Evidence of such a serum factor has been found in three varieties of this disease: 1) the idiopathic type, 2) the congenital type, and 3) the drug hyper sensitivity type (e.g., quinidine and sedormid). They have been grouped together as the immunologic thrombocytopenic purpuras. (The drug reaction variety does not include thrombocytopenia due to direct megakaryocyte damage by agents such as benzol, nitro gen mustards, and the anti-metabolite drugs, which can produce bone marrow aplasia of all blood cell elements. ) Early workers called this anti-platelet serum factor an antibody. The term "platelet antibody" has been used by many investigators (and in this study) for the sake of convenience; however, the serum factor has not always been proved to be a true, specific antibody, nor has the platelet been proved to be the specific antigenic stimulus.

The aim of this study is 1) to review the immunologic research in thrombocytopenia, and 2) to investigate the sera of patients with idiopathic thrombocytopenic purpura for platelet antibody by means of the technique of immune adherence.