Immune thrombocytopenic purpura secondary to Helicobacter pylori.

Immune thrombocytopenic purpura is a disorder characterized by decreased platelet count that may be secondary to infectious or autoimmune etiologies. We present a patient with upper gastrointestinal bleeding complicated by severe thrombocytopenia. Endoscopy revealed gastritis with pathology positive for Helicobacter pylori. Platelet count normalized after triple antibiotic therapy. The precise mechanism by which H. pylori causes immune thrombocytopenic purpura remains unclear; however, there are several plausible mechanisms. This case highlights the importance of keeping H. pylori in the differential in patients presenting with thrombocytopenia.

Nattokinase-Associated Hemoperitoneum in an Elderly Woman.

The consumption of herbal supplements has become increasingly popular the United States. One such herbal supplement that is available at pharmacies and grocery stores is nattokinase. Nattokinase, a byproduct of soybean fermentation, may have some thrombolytic properties. We present the case of a patient who developed hemoperitoneum and subsequently passed away. We review the potential mechanisms of action of nattokinase and warn against consumption of herbal supplements, especially nattokinase.