Corticotropin (Acth) and Cortisone in Idiopathic Thrombocytopenic Purpura

Idiopathic thrombocytopenic purpura may be due to various pathogenetic mechanisms.1It has been recognized recently that, at least in the acute type of the disease, allergic and immunologic factors may be responsible for the occurrence of thrombocytopenia. Since corticotropin (ACTH) and cortisone have been shown to modify immunologic and allergic reactions in various clinical conditions, it appeared of interest to investigate their possible therapeutic value in idiopathic thrombocytopenic purpura. Moreover, we have obtained evidence that corticotropin and cortisone exert a stimulatory effect on the bone marrow cells, including the megakaryocyteplatelet system. Reports of the treatment of idiopathic thrombocytopenic purpura with the steroid hormones are few and their conclusions justifiably cautious, in view of the extreme variability in the course of the disease. Robson and Duthie2studied the effect of cortisone in two cases of idiopathic thrombocytopenic purpura. They noted prompt improvement of the capillary fragility, while the bleeding