0

The full content of Annals is available to subscribers

Subscribe/Learn More  >
Editorials |

Quinine Sensitivity: A New Cause of the Hemolytic Uremic Syndrome

Richard H. Aster, MD
[+] Article and Author Information

Medical College of Wisconsin, Milwaukee, WI 53233. Requests for Reprints: Richard H. Aster, MD, The Blood Center, 1701 West Wisconsin Avenue, Milwaukee, WI 53233. Grant Support: By grant HL13621 from the National Heart, Lung, and Blood Institute.


Copyright 2004 by the American College of Physicians


Ann Intern Med. 1993;119(3):243-244. doi:10.7326/0003-4819-119-3-199308010-00012
Text Size: A A A

In this issue of Annals, Maguire and coworkers [1] describe two patients who had symptoms and laboratory findings consistent with the adult hemolytic uremic syndrome of acute onset. In addition to the expected findings of microangiopathic hemolytic anemia, thrombocytopenia, and renal failure, both patients had neutropenia and low-grade disseminated intravascular coagulation. One patient had a similar episode about 2 years earlier, and the other reported many previous episodes. The initial histories that the patients gave failed to identify exposure to medications. However, the urine of one patient contained quinine, the probable source of which was tonic water, and circumstantial evidence suggested that the second patient had taken quinine to prevent nocturnal leg cramps. Quinine was also implicated by the finding of quinine-dependent antibodies reactive with platelets, granulocytes, and erythrocytes in the serum of both patients. Clearly these patients had quinine-induced hemolytic uremic syndrome, a recently described syndrome [2] that can occur with or without associated disseminated intravascular coagulation or granulocytopenia [34].

First Page Preview

View Large
First page PDF preview

Figures

Tables

References

Letters

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Comments

Submit a Comment
Submit a Comment

Summary for Patients

Clinical Slide Sets

Terms of Use

The In the Clinic® slide sets are owned and copyrighted by the American College of Physicians (ACP). All text, graphics, trademarks, and other intellectual property incorporated into the slide sets remain the sole and exclusive property of the ACP. The slide sets may be used only by the person who downloads or purchases them and only for the purpose of presenting them during not-for-profit educational activities. Users may incorporate the entire slide set or selected individual slides into their own teaching presentations but may not alter the content of the slides in any way or remove the ACP copyright notice. Users may make print copies for use as hand-outs for the audience the user is personally addressing but may not otherwise reproduce or distribute the slides by any means or media, including but not limited to sending them as e-mail attachments, posting them on Internet or Intranet sites, publishing them in meeting proceedings, or making them available for sale or distribution in any unauthorized form, without the express written permission of the ACP. Unauthorized use of the In the Clinic slide sets will constitute copyright infringement.

Toolkit

Buy Now

to gain full access to the content and tools.

Want to Subscribe?

Learn more about subscription options

Advertisement
Related Articles
Topic Collections
PubMed Articles

Buy Now

to gain full access to the content and tools.

Want to Subscribe?

Learn more about subscription options

Forgot your password?
Enter your username and email address. We'll send you a reminder to the email address on record.
(Required)
(Required)