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Quinine-induced hemolytic-uremic syndrome.

N F Crum1, P Gable

  • 1Department of Internal Medicine, Naval Medical Center, San Diego, Calif 92134-5000, USA.

Southern Medical Journal
|August 3, 2000
PubMed
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Quinine use for leg cramps can cause hemolytic-uremic syndrome (HUS). This case highlights the importance of plasmapheresis for treating this rare but serious quinine side effect.

Area of Science:

  • Nephrology
  • Hematology
  • Pharmacology

Background:

  • Quinine is commonly prescribed for nocturnal leg cramps despite lacking FDA approval.
  • Quinine-induced hemolytic-uremic syndrome (HUS) is a rare but serious adverse effect.

Observation:

  • This report details the 15th documented case of quinine-induced HUS.
  • The patient required an extended plasmapheresis treatment course of 37 days (16 sessions).

Findings:

  • Quinine-induced HUS is likely mediated by quinine-dependent antibodies targeting blood cells.
  • Antibody-induced endothelial damage leads to nephropathy, microangiopathic hemolytic anemia, and thrombocytopenia.

Implications:

  • Plasmapheresis is considered the standard of care for severe quinine-induced HUS.

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  • Despite its severity, quinine-induced HUS has an excellent prognosis with no reported fatalities.