Metoclopramide-induced delayed non-thrombocytopenic purpuric rash

A 62-year-old man with no drug allergies was admitted for coronary artery bypass grafting. Postoperatively, metoclopramide was commenced for the treatment of gastroparesis. Ten days after the drug was initiated a purpuric rash was noticed on his lower limbs. His platelet count was normal. Infection was excluded and the cause was not obvious. No change was noticed in the condition of rash despite discontinuation of all other medications started in the hospital one at a time. The rash later began to subside upon discontinuation of metoclopramide. A rechallenge was not attempted for ethical reasons. In conclusion, metoclopramide was considered to be the causative agent of this rash as it subsided after the discontinuation of metoclopramide.