Autoimmune Thrombocytopenic Purpura in Homosexual Men

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Abstract
Since Nov. 1980 11 cases of severe autoimmune thrombocytopenic purpura in homosexual men were diagnosed; their mean platelet count (.+-. SE) was 16,000 .+-. 3000/mm3. All patients had been sexually active wiht multiple partners and exposed to numerous viruses and drugs. During this period, 20 cases of classic autoimmune thrombocytopenic purpura in heterosexual persons were also diagnosed, with a normal women to men ratio of 3:1. Eight of 9 homosexual patients had elevated platelet IgG compared with normal values in 8 of 10 homosexual control subjects having normal hemograms (P < 0.01). All responded moderately or completely to steroids. The 3 patients who had splenectomy had excellent responses. Four of 5 patients had a decreased helper/suppressor T cell ratio compared to healthy controls (P < 0.001). Circulating immune complexes and total .gamma. globulin levels were elevated and lymphocytes relatively decreased in homosexual patients compared with homosexual controls (P < 0.05). Some sexually-active homosexual men seem to have an increased incidence of an immune regulation disorder directed against platelets.