Successful treatment of primary immune thrombocytopenia accompanied by diabetes mellitus treated using clarithromycin followed by prednisolone

Macrolides have immunomodulatory effects including anti-inflammatory effects as well as antibacterial activity. In consideration of these immunomodulatory effects, we report a patient with primary immune thrombocytopenia (ITP) treated using clarithromycin (CAM), a macrolide, followed by prednisolone (PSL). A 78-year-old man with thrombocytopenia was admitted to our hospital for further examination. Initial laboratory data showed reduced platelet counts (1.7 × 104/μL). Finally, we diagnosed the patient as having primary ITP. Because the patient was suffering from diabetes mellitus (DM), he was treated with CAM as an alternative to PSL. The platelet count increased to 6.1 × 104/μL. The CAM treatment was terminated owing to gradual nausea and palpitation. During the CAM treatment, the DM was under control. We reinitiated treatment for ITP. The patient was successfully treated using PSL without severe hyperglycemia. This case shows that CAM treatment may represent a useful option for ITP patients who cannot receive PSL due to DM.