Thrombocytopenic purpura: an unusual complication of eradication therapy for Helicobacter pylori

A case of severe thrombocytopenic purpura is described in a 56-year-old female following Helicobacter pylori eradication therapy consisting of omeprazole, clarithromycin and amoxycillin. The pathogenesis of this patient's thrombocytopenia appears to be quite complex. Whilst it was clearly triggered by antibiotic treatment, a direct toxic mechanism does not provide an adequate explanation for the severity and lack of responsiveness to drug treatment. It is tempting to suggest that an immunological mechanism and splenomegaly were also involved.