John Freedman John W Semple Alan H Lazarus

Valery Leytin Heyu Ni

Margaret L Rand Victor S Blanchette

HSC CBSSMH

ITP

Idiopathic thrombocytopenic purpura Immune thrombocytopenic purpura

From Hippocrates to Bussel

(and a few side-trips in between)

immune

thrombocytopenia

purpura

Greco-Roman: Hippocrates, Galen –

life based on four elements: Fire, air, earth, water

Blood was one of the four ‘humors’ (air): made in liver, sloshed around through heart where mixed with air

Brew of willow tree leaves (salicylates) as analgesic and antipyretic

Spleen: source of black bile; “organ full of mystery”

Hippocrates

460-377 BCE

Galen

CE 129-circa 210

[Juliana Anicia Ms, CE 487]

Red “eminences”/spots associated with pestilential fevers (plague).

Porphyra

Gastropod mollusc janthina janthina

Purpura

πορφυρα

C10th: Avicenna (Canon) --- chronic purpura

Amatus Lusitanus (Joo Rodrigues de Castelo Branco)[1511-1568]

Physician, researcher in anatomy, internal medicine, dermatology, mental illness.

Peripatetic Converso who fled from Salamanca to Portugal, Ferrara, Ancona, Dubrovnik, Salonika, but was nonetheless physician to several monasteries and to Pope Julius III.

Between 1541 and 1561 wrote seven centuriae: each 100 case histories, their treatment, results and pathology, accompanied by learned explanations.

1658

X 300

1632-1723

Anton van Leeuwenhoek

1735

linguist physician

composerpoet

1775

1808

The Englishman, William Hewson (1739-1774) was probably the first to observe some platelets.

Joseph Lister, Lord

1827-1912

Founder of aseptic surgery

Joseph Jackson Lister

1786-1869

Wine merchant

1828

1842

+ Foucault = daguerrotype

Alfred Donne (1801-1878)

Child care; breastfeeding

1840s to 1860s:

Gulliver, Addison: independently made what are probably the first drawings of platelets

Zimmerman: ‘elementary bodies’ which came from lymphatics and were precursors of red blood cells;(Hematoblasts)

Jones, Beale, Simon, Schultze: platelets were fibrin clots (? derived from leukocytes)

Schmidt in Estonia: ? A cell between erythrocyte and leukocyte

Addison 1842

Brewer DB: Br J Haematol 133:251-258, 2006

Professor of Anatomy, Bonn

1874

Aequanimitas

Osler

“It must still be confessed that we know nothing about the origin or destiny of these corpuscles”

1882

“The existence of a constant blood particle, differing from red and white blood cells, has been suspected by several authors for some time”

Despite the work’s title (“…et sur son importance dans la trombose et dans la coagulation”), Bizzozero did not focus on the hemostatic or hemorrhagic role of platelets, and appears not to have recognized platelets as a factor in purpura.

rbc

platelets

Georges Hayem (1841-1935):

A founder of haematology.

Small elements in blood; tendency to clump and to change shape;in 1883, coined term platelet.

Hôpital Tenon; St Antoine: several anemias, digestion, stomach, rbc counting, cholera

In 1884, Krauss related purpura hemorrhagica to a decrease in circulating platelets

1887

1895

1890

Relation of megakaryocytes to platelets

proplatelets JCB9909028.V1.movTake off full screen

1915: Frank (Breslau) recognized that megakaryocytopoiesis was normal in ITP

1915

1916 Minot Failure of transfusion in ITP

1916 Minot Platelet destruction due to “some reaction”

1916 Kaznelson Spleen site of platelet destruction?(Prague) Splenectomy in ITP

Other treatments at this time included irradiation by mercury vapor lamps, snake venom, splenic irradiation.

1938 Troland & Lee ‘Thrombocytopen’ from ITP splenic extracts

Pla

tele

t cou

nt

1940 Wiseman Clinical diagnostic criteria for ITP

1946 Curtis Failure of splenectomy due to accessory spleen

Damashek & Miller, however, continued to argue that ITP was due to a fundamental abnormality of the spleen which ‘exerts an unusual effect on the production of platelets from the megakaryocytes in the marrow’

Harrington et al, J Lab Clin Med 38:1, 1951

1951

plasma

Passive transfer of ITP with ITP plasma

Carl V Moore

1951 Evans Plasma factor = anti-platelet antibody

1951 Damashek Distinction of acute versus chronic ITP

1951 Wintrobe Use of corticosteroids in ITP

Maxwell WintrobeWilliam Damashek

1972 --- Sartorius, Am J Ped Hematol Oncol 6:165, 1984

1984: First randomized trial of steroids in ITP

Lien

1970s

1975 Dixon Measurement of PA-IgG

1981 Imbach IVIG in ITP

1983 Salama Anti-D in ITP

1970s – 1990s Humoral immunity in ITP; antibody specificity New drugs for refractory patients

1990s - Dysregulation of cellular immunity in ITP

            

 

                     

Literature on history of plateletsJones HW, Tocantins LM: The history of pupura hemorrhagica. Ann Med Hist 5:349-359, 1933.

Robb-Smith AHT: How the platelets were discovered. Br J Haematol 13:618-639, 1967.

Blanchette M, Freedman J: The history of idiopathic thrombocytopenic purpura (ITP). Transfus Sci 19:231-236, 1998.

Freedman J, Blanchette M: Idiopathic thrombocytopenic purpura (ITP): a historical odyssey. Acta Paediatr Suppl 424:3-6, 1998.

Mustard JF, Kinlough-Rathbone RL, Packham MA: History of platelets. In: Platelets in thrombotic and nonthrombotic disorders: pathophysiology, pharmacology and therapeutics . Gresele P, Page C, Fuster V, Vermylen J, eds. Cambridge University Press, Cambridge, 2002.

Imbach P, Kuhne T, Signer E: Historical aspects and present knowledge of idiopathic thrombocytopenic purpura. Br J Haematol 119:894-900, 2002.

Izaguirre-Avila R: El descubrimiento de las plaquetas. Revista Biomedica Vol 8, 1997.