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Quinine-induced hemolytic-uremic syndrome.
1Department of Internal Medicine, Naval Medical Center, San Diego, Calif 92134-5000, USA.
Southern Medical Journal
|August 3, 2000
Summary
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.
- Despite its severity, quinine-induced HUS has an excellent prognosis with no reported fatalities.