Thrombocytopenic purpura in HIV-seronegative users of intravenous cocaine.

Severe thrombocytopenic purpura occurred in seven patients who had histories of recent or current intravenous cocaine use. All of the patients denied heroin use and all were seronegative for antibodies to the human immunodeficiency virus (HIV). The seven patients had normal or increased numbers of megakaryocytes in their bone marrows. While receiving corticosteroid therapy their platelet counts rose to 10(11)/L over periods ranging from 5 to 11 days. In view of the widespread use of cocaine, severe thrombocytopenia in the HIV-seronegative patient should suggest the possibility of current or recent intravenous use of cocaine.