Thrombocytopenic Purpura Associated With Hydrochlorothiazide Therapy

Chlorothiazide and hydrochlorothiazide are widely used, effective, orally given nonmercurial diuretic and antihypertensive agents. A principal action of these drugs is marked enhancement of the excretion of sodium and chloride and to a lesser extent of potassium. Although they possess the advantage of being relatively safe drugs, there are a few sidereactions of importance, including nausea, skin rash, anorexia, headache, restlessness, and constipation. Potentially serious side-effects include postural hypotension; circulatory collapse; sodium, potassium, and chloride depletion; temporary aggravation of hyperuricemia; and acceleration of hepatic coma in patients with severe liver disease.1Two cases of purpura with thrombocytopenia due to administration of chlorothiazide (Diuril) have recently been reported.2 Among a group of patients treated with hydrochlorothiazide a case of thrombocytopenia with purpura presumed to be due to administration of this drug was encountered and is here described. The problem of purpura was complicated by adynamic ileus secondary to hypopotassemia.