Quinine-induced immune thrombocytopenia associated with hemolytic uremie syndrome: A new clinical entity

Abstract

Three patients are described who developed severe thrombo-cytopenia, 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 thrombocvtopenia 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. © 1991 by The American Society of Hematology.