[Follow-up of Werlhof disease after onset of treatment with maprotiline].

Whereas leucocytopenia is reported to be a relatively frequent side-effect of treatment with tricyclic and tetracyclic antidepressants and atypical neuroleptic agents, isolated thrombocytopenias are rare. To our knowledge there are no reports of thrombocytopenia in connection with the tetracyclic antidepressant maprotiline. This report describes the case of a 53-year-old female patient with neurotic depression and an initially unsuspected chronic idiopathic thrombocytopenic purpura (ITP). Following previous treatment with an angiotensin-converting enzyme inhibitor, cilazapril, and an estrogen derivative, the patient developed an episode of the ITP after beginning treatment with maprotiline. The possible aetiology and the course of the illness are discussed.