Joel P. Freiman, MD, MPH
To the Editor: Quinine sulfate is widely used for the treatment of nocturnal leg cramps, although studies (1-3) have shown it to be of minimal benefit. One of the most serious and well-recognized side effects of quinine sulfate is thrombocytopenia. The mechanism of this reaction appears to be the formation of drug antibody complexes with an affinity for some component of the platelet membrane (4). The Food and Drug Administration (FDA) has received two reports of fatal quinine-induced thrombocytopenia.
Patient 1, a 41-year-old woman, initially presented with sudden onset of severe abdominal pain radiating to her back. She had marked
Freiman JP. Fatal Quinine-Induced Thrombocytopenia. Ann Intern Med. ;112:308–309. doi: 10.7326/0003-4819-112-4-308
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Published: Ann Intern Med. 1990;112(4):308-309.
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