ABSTRACT

A 68-year-old man was hospitalized for petechial rash on the trunk, legs and face accompanied by bullae in gingival bleeding. These effects occurred approximately twomonths after glimepiride was started (1 mg daily). Other concurrent medications included pipotiazine (12.5 mg every six weeks), and trihexyphenidyl(4 mg daily). Glimepiride was stopped for a short period of time (less than two weeks). When restarted the patient developed hemorrhagic syndrome marked by thrombocytopenia (1 X 10IL). A bone marrow biopsy was negative for infectious processes, as were other tests for viral or bacterial etiologies. All medications were stopped and treatment included prednisone (1 mglkglday) and immunoglobulins (0.4 glkglday). The hemorrhagic syndrome improved by one week but the platelet count did not return to baseline until after four weeks of prednisone therapy. At six months the platelet count was still normal.