Isolated Thrombocytopenia in Homosexual Men — Longitudinal Follow-Up

  • Donald I. Abrams
  • Dobri D. Kiprov
  • Paul A. Volberding
Part of the Advances in Experimental Medicine and Biology book series (AEMB, volume 187)


One of the most clinically challenging, yet infrequently discussed, of the AIDS-associated syndromes is the problem of immune thrombocytopenic purpura (ITP). ITP is a diagnosis more frequently encountered in its acute form in children following viral infections and in its chronic presentation in middle-aged women. Morris et al published their account of auto-immune thrombocytopenic purpura in homosexual men in June 1984(1). Their manuscript described a cluster of ITP in 12 homosexual men with backgrounds similar to those recognized in patients with acquired immunodeficiency syndrome. Subsequently the problem has also been recognized in narcotics addicts and hemophiliacs without other manifestations of AIDS(2,3). To date, 32 homosexual men with isolated thrombocytopenia of immune origin have been evaluated in the AIDS Clinic at San Francisco General Hospital. Our experience with this group constitutes the basis of the following discussion.


Acquire Immunodeficiency Syndrome Immune Thrombocytopenic Purpura Pneumocystis Carinii Pneumonia Elevated Erythrocyte Sedimentation Rate Prednisone Therapy 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Morris L. Distenfeld A, Amorosi E, and Karpatkin S. Autoimmune thrombocytopenic purpura in homosexual men. Ann Int Med 96 (Part I): 714–717, 1984.Google Scholar
  2. 2.
    Savona S, Nardi M, and Karpatkin S. Thrombocytopenic purpura in narcotics addicts. Blood 64: 240a, 1984 (abstract).Google Scholar
  3. 3.
    Brettler DB, Szymanski 10, Sullivan JL, Platelet associated IgG in hemophilia. Blood 64: 240a, 1984 (abstract).Google Scholar
  4. 4.
    Abrams DI, Chinn EK, Lewis BJ, et al. Hematologic manifestations in homosexual men with Kaposi’s sarcoma. Am J Clin Pathol 81: 13–18, 1984.PubMedGoogle Scholar
  5. 5.
    Jaffe HS, Ammann AJ, Abrams DI, Lewis BJ, and Golden JA. Complications of co-trimoxazole in treatment of AIDS- associated Pneumocystis carinii pneumonia in homosexual men. Lancet ii: 1109–1111, 1983.Google Scholar
  6. 6.
    Abrams DI, Lewis BJ, Beckstead JH, Casavant CA and Drew WL. Persistent diffuse lymphadenopathy in homosexual men: Endpoint or prodrome? Ann Int Med 100: 801–808, 1984.PubMedGoogle Scholar
  7. 7.
    Abrams DI. Lymphadenopathy in homosexual men. IN: Advances in Host Defences, Vol. 4, Gallin J and Fauci A, Raven Press, 1985. In press.Google Scholar
  8. 8.
    Abrams DI, Volberding PA, Linker CA, et al. Immune thrombocytopenic purpura in homosexual men: Clinical manifestations and treatment results. Blood 62: 108a, 1983 (abstract).Google Scholar
  9. 9.
    Kiprov DD, Morand P, Moss A, Sherman JC and Spira T. Correlation of antilymphocyte bodies (ALA) with seropositivity for lymphadenopathy virus (LAV). Proceedings of International Conference on Acquired Immunodeficiency Syndrome, 1985 (submitted).Google Scholar
  10. 10.
    Abrams DI, Kiprov DD, Goedert MG, et al. HTLV-III antibodies and development of AIDS in homosexual men presenting with immune thrombocytopenia. Proceedings of International Conference on Acquired Immunodeficiency Syndrome, 1985 (submitted).Google Scholar
  11. 11.
    Walsh CM, Nardi MA, and Karpatkin S. On the mechanism of thrombocytopenic purpura in sexually active homosexual men. N Engl J Med 311: 635–639, 1984.PubMedCrossRefGoogle Scholar
  12. 12.
    Strieker RB, Abrams DI, Corash L and Shuman MA. Target platelet antigen in AIDS-related immune thrombocytopenia. Blood 64: 241a, 1984 (abstract).Google Scholar
  13. 13.
    Saxon A, Stevens RH, Ramer SJ, Clements PJ, and Yu DTY. Glucocorticoids administered in vivo inhibit human suppressor T lymphocyte function and diminish B lymphocyte responsiveness in in vitro immunoglobulin synthesis. J Clin Invest Vol. 61: 922–930, 1977.CrossRefGoogle Scholar
  14. 14.
    Zweiman B, Atkins PC, Bedard PM, Flaschen SL and Lisak RP. Corticosteroid effects on circulating lymphocyte subset levels in normal humans. J Clin Immunol 4: 151–155, 1984.PubMedCrossRefGoogle Scholar
  15. 15.
    Abrams D, Kiprov D, Strieker R, and Volberding P. Prednisone therapy in AIDS-related immune thrombocytopenia ( ITP ): Clinical, hematologic and immunologic consequences. Proceedings American Society of Clinical Oncology (ASCO ) 1985 (submitted).Google Scholar

Copyright information

© Plenum Press, New York 1985

Authors and Affiliations

  • Donald I. Abrams
    • 1
  • Dobri D. Kiprov
    • 1
  • Paul A. Volberding
    • 1
  1. 1.AIDS ClinicSan Francisco General Hospital and Children’s Hospital of San FranciscoSan FranciscoUSA

Personalised recommendations