Cocaine-associated thrombocytopenia

In this retrospective report, four male intravenous cocaine users are described with thrombocytopenia temporally related to the use of the drug. Mucosal bleeding and megakaryocytic hyperplasia occurred in all patients. The cocaine-thrombocytopenia relationship was especially apparent in one individual who developed thrombocytopenia on two separate occasions after intravenous cocaine use. Three patients were treated successfully with high doses of intravenous gamma globulin and steroids, while one patient required splenectomy. Along with the widespread use of cocaine in our society has come the recognition of a number of adverse effects of the drug. Thrombocytopenia may be added to a list that includes myocardial infarction and central nervous system complications.