Reversible nonthrombocytopenic palpable purpura associated with metoclopramide.
OBJECTIVE
To report a case of reversible nonthrombocytopenic palpable purpura associated with metoclopramide.


METHODS
A 72-year-old white man was admitted for worsening palpable purpura over a two-day period. Two days prior to admission, metoclopramide 10 mg orally three times per day was started for a gastrointestinal condition. Upon admission, all drugs were continued except metoclopramide. Over the next two days, the purpura began to resolve. Platelet count was within normal limits on admission and the patient developed no serious consequences because of the purpura.


CONCLUSIONS
According to the literature, reversible nonthrombocytopenic palpable purpura has not been previously reported with metoclopramide. A search of MEDLINE (1966 to November 1998) and International Pharmaceutical Abstracts (1970 to November 1998) did not reveal a similar case. Although a rechallenge was not tried, this case appears to demonstrate a temporal relationship between the initiation and discontinuation of metoclopramide and the onset and resolution of symptoms. Similar cases of this reaction have been reported with procainamide, which is structurally similar to metoclopramide.


CONCLUSIONS
Metoclopramide may cause reversible nonthrombocytopenic vascular-type palpable purpura. Discontinuation of the drug appeared to be responsible for the resolution of symptoms.
Goad
J A
JA
Department of Clinical Pharmacy, School of Pharmacy, University of Southern California, Los Angeles 90033, USA. goad@hsc.usc.edu
D015746:Abdominal Pain / Q000188:drug therapy; D000368:Aged; D003922:Diabetes Mellitus, Type 1 / Q000503:physiopathology; D006801:Humans; D011695:IgA Vasculitis / Q000139:chemically induced*; D016239:MEDLINE; D008297:Male; D008787:Metoclopramide / Q000009:adverse effects* / Q000627:therapeutic use