Quinine induced thrombotic microangiopathy and thrombocytopenia: A teaching hospital’s perspective

• 作者: Aaron J. Franke William Paul Skelton IV
• 来源期刊: 全科医学进展(英文)
• 学科: 医学
• 关键词: QUININE TMA DRUG reaction DITMA THROMBOCYTOPENIA
• 年，卷（期）: 2019,（1）
• 页码范围: 9-12
• 页数: 4页
• 分类号: R

摘要

Although quinine is an infrequently prescribed drug, with malaria treatment being its only FDA-approved indication, unwitting exposure via beverages (e.g., tonic water), over the counter herbal remedies and illegal recreation drugs still occur. We present a unique case of a female patient who denied any known prior history of quinine exposure, who after being prescribed quinine tablets for restless leg syndrome, developed an immune-related thrombotic microangiopathy with thrombocytopenia and subsequent multi-organ failure. It was later elucidated that her only known potential source of prior quinine exposure was a remote history of crackcocaine use. The patient survived this rare and severe inflammatory response with recovery of renal function and was able to discontinue dialysis.