Quinine-induced immune thrombocytopenia associated with hemolytic uremic syndrome: a new clinical entity.
Three patients are described who developed severe thrombocytopenia, microangiopathic hemolytic anemia, and acute renal failure after ingestion of quinine. In one patient, the same clinical findings recurred several months later after another exposure to quinine. Serum from one patient contained quinine-dependent IgG antibodies reactive with the platelet glycoprotein (GP) Ib/IX complex. In the second and third cases, serum contained IgG and IgM antibodies reactive with both the GP Ib/IX and IIb/IIIa complexes in the presence of quinine. Quinine appears to have induced both immune thrombocytopenia and the hemolytic uremic syndrome (HUS) in these individuals. Findings made in these cases may have implications for the pathogenesis of some forms of HUS.
Gottschall
J L
JL
Department of Medicine (Division of Nephrology), Medical College of Wisconsin, Milwaukee.
Elliot
W
W
Lianos
E
E
McFarland
J G
JG
Wolfmeyer
K
K
Aster
R H
RH
D000210:Acute-Phase Reaction / Q000097:blood; D000328:Adult; D000368:Aged; D000937:Antigen-Antibody Reactions / Q000187:drug effects; D001323:Autoantibodies / Q000276:immunology; D001792:Blood Platelets / Q000276:immunology; D005260:Female; D006463:Hemolytic-Uremic Syndrome / Q000139:chemically induced* / Q000276:immunology; D006801:Humans; D008875:Middle Aged; D010980:Platelet Membrane Glycoproteins / Q000276:immunology; D011803:Quinine / Q000009:adverse effects*; D013921:Thrombocytopenia / Q000139:chemically induced* / Q000276:immunology
D001323:Autoantibodies; D010980:Platelet Membrane Glycoproteins; D011803:Quinine