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Quinine-induced immune thrombocytopenia associated with hemolytic uremic
syndrome: a new clinical entity
JL Gottschall, W Elliot, E Lianos, JG McFarland, K Wolfmeyer and RH Aster
Department of Medicine (Division of Nephrology), Medical College of
Wisconsin, Milwaukee.
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.
Volume 77,
Issue 2,
pp. 306-310,
01/15/1991
Copyright © 1991 by The American Society of Hematology
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