Korean J Hematol.  2011 Jun;46(2):139-142. 10.5045/kjh.2011.46.2.139.

Successful treatment with erythromycin for idiopathic thrombocytopenic purpura

• Ohe M
• Hashino S

• KMID: 1782780
• DOI: http://doi.org/10.5045/kjh.2011.46.2.139

Abstract

Macrolides have both immunomodulatory and antibacterial effects. We report 3 cases of primary immune thrombocytopenia (ITP) patients who were successfully treated with macrolides, irrespective of Helicobacter pylori (H. pylori) infection status. Case 1, an 88-year-old woman who was an H. pylori-positive ITP patient, was treated with clarithromycin (CAM). CAM was effective temporarily. As an alternative to CAM, she was successfully treated with erythromycin (EM) for more than 7 months. Case 2, a 61-year-old man who was an H. pylori-negative ITP patient, was unsuccessfully treated with CAM but successfully treated with EM. Case 3, a 75-year-old woman who was a H. pylori-negative ITP patient, was treated with CAM. CAM was effective temporarily. After approximately 6 months, she was treated with EM for a common cold, and her platelet count increased rapidly. Based on these findings, macrolide treatment was effective for ITP. The effectiveness of macrolides might suggest immunomodulatory effects as well as antibacterial effects for H. pylori.

Keyword

Idiopathic thrombocytopenic purpura; Erythromycin; Macrolide

MeSH Terms

Aged
Aged, 80 and over
Clarithromycin
Common Cold
Erythromycin
Female
Helicobacter pylori
Humans
Macrolides
Middle Aged
Platelet Count
Purpura, Thrombocytopenic, Idiopathic
Thrombocytopenia
Clarithromycin
Erythromycin
Macrolides

Figure

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  Fig. 1 Change of platelet counts following clarithromycin (CAM) and erythromycin (EM) treatments.

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  Fig. 2 Change of platelet counts following prednisolone (PSL), methylprednisolone (mPSL), CAM, and EM treatments.

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  Fig. 3 Change of platelet counts following CAM and EM treatments.

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