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Esophageal variceal bleeding can be serious or life threatening. Drug-induced thrombocytopenia can further complicate such bleeding episodes. Thrombocytopenia because of sandostatin has been reported in the literature only once previously. We describe a case of sandostatin-induced reversible thrombocytopenia with a positive rechallenge. Platelet count decreased during administration of sandostatin and recovered only when the infusion was halted. The proposed mechanism of thrombocytopenia during both episodes is immunologic. Physician awareness of sandostatin-induced thrombocytopenia can prevent unnecessary complication during episodes of esophageal variceal bleeding and is rapidly reversed with discontinuation of the drug.

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