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In a retrospective study undertaken to document the frequency of thrombocytopenia in cases of leptospirosis, 18 of 32 patients (56.3%) had a platelet count of 100 × 103/mm3 or less. Renal failure occurred in 72.2% of thrombocytopenic patients and in 21.4% of patients with normal platelet counts. The association of thrombocytopenia and renal failure was significant (P < 0.02). The common occurrence of thrombocytopenia and its association with acute renal failure in patients with leptospirosis has not previously been reported.