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Quinine-induced disseminated intravascular coagulation
R L Spearing1, C M Hickton, P Sizeland
1Department of Haematology, Christchurch Hospital, New Zealand.
Lancet (London, England)
|December 22, 1990
Summary
Quinine tablets taken for leg cramps can cause recurrent disseminated intravascular coagulation (DIC) in susceptible individuals. This serious condition is linked to quinine-dependent antibodies targeting platelets.
Area of Science:
- Hematology
- Immunology
- Pharmacology
Background:
- Disseminated intravascular coagulation (DIC) is a critical condition characterized by widespread activation of coagulation.
- Quinine is an alkaloid derived from cinchona bark, historically used for malaria and muscle cramps.
Observation:
- Three women developed recurrent DIC following the ingestion of quinine tablets for leg cramps.
- These patients exhibited circulating quinine-dependent antibodies specifically targeting platelets.
Findings:
- Two of the three women showed initial signs of antibody consumption, indicated by low antibody titers.
- Antibody titers rose sharply in the subsequent days and remained elevated for extended periods, suggesting a persistent immune response.
Implications:
- This case series highlights a potential drug-induced immune thrombocytopenia and coagulopathy associated with quinine.
- Clinicians should consider quinine as a potential trigger for DIC in patients with unexplained coagulopathies, especially after quinine ingestion.
- Further research into quinine-induced immune reactions is warranted to understand the underlying mechanisms and risk factors.