The response of a patient with chronic severe idiopathic thrombocytopenic purpura (ITP), refractory to all forms of therapy, to the controlled use of anticoagulation is described. A significant elevation of the platelet count and clinical improvement accompanied the use of heparin and was sustained for a two-week period. In addition, a short-lived response was obtained with warfarin sodium. Studies of the patient’s coagulation factors during the trial of heparin therapy indicated that accelerated intravascular coagulation was not an explanation for the thrombocytopenia or for the response to anticoagulant therapy. These results provide additional evidence that anticoagulant drugs affect blood platelet economy and indicate that further investigation of the underlying mechanisms is needed.

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