Quinine-induced thrombocytopenia following intravenous use of heroin.
Profound thrombocytopenia developed in a 22-year-old man after intravenous use of heroin. A high-titer, quinine-dependent, platelet-specific antibody was detected in his serum using lysis of normal platelets labeled with chromium 51 and an electroimmunoassay for measurement of platelet-associated IgG. The antibody was specific for quinine and failed to react with platelets in the presence of quinidine hydrochloride or two structural analogues of heroin. Quinine, a common adulterant found in heroin, was detected in the patient's blood and urine. On the basis of these observations, the patient was judged to have quinine-induced immunologic thrombocytopenia. To our knowledge, this report is the first to confirm that quinine used as an adulterant can induce immunologic thrombocytopenia following an injection of heroin.
D000328:Adult; D001792:Blood Platelets / Q000276:immunology; D002860:Chromium Radioisotopes; D004340:Drug Contamination; D003932:Heroin / Q000008:administration & dosage / Q000009:adverse effects*; D006801:Humans; D007118:Immunoassay / Q000379:methods; D007074:Immunoglobulin G / Q000032:analysis; D007275:Injections, Intravenous; D008297:Male; D011803:Quinine / Q000009:adverse effects* / Q000097:blood / Q000276:immunology; D013921:Thrombocytopenia / Q000097:blood / Q000139:chemically induced* / Q000276:immunology
D002860:Chromium Radioisotopes; D007074:Immunoglobulin G; D003932:Heroin; D011803:Quinine