1956 年 45 巻 1 号 p. 7-14
We have had recently three cases of the chronic type of idiopathic thrombocytopenic purpura. All of the cases showed remarkable increase of platelets by splenectomy. The genesis of this disease researched, the existence of platelet reducing factor was found in patients sera and extracts of the spleen. And yet it was made sure through bone marrow streaming examination for this factor to act directly upon the bone marrow.
This factor transfered into the cerebrospinal liquor and was secreted in the urine. Moreover, the function (movement and platlet production) of the Megakaryocyte was observed by tissue culture of patients bone marrow and taken microcinematograms in success. The number of the megakaryocytes decreased in two cases and increased in one case of the three compared with normal.
Most of them had neither motility nor tentacle-like filament in spite of their maturity, and thus showed a severe hypofunction. The number of the megakaryocytes after splenectomy in all cases recovered to the normal.
They stretched out many strange and complicated pseudopodia in all direction, and showed vigorous migration as well as striking formation of tentacle-like filament.
A phenomenon of platlet separation was sometimes observed at the top of their filament.
From above-mentioned findings, the followings could be considered; The splenectomy on the patients with chronic idiopathic thrombocytopenic purpura resulted in disappearance of the splenogenic toxic substance and immediate recovery of both function and number of the megakaryocytes by elimination of the disturbance of their development and production.
It is concluded that the genesis of chronic idiopathic thrombocytopenic purpura mainly exists in the hypofunction of the megakaryocytes.