Concomitant acral necrosis and haemolytic uraemic syndrome following ingestion of quinine

J Postgrad Med. 2002 Jul-Sep;48(3):197-8.

Abstract

Thrombotic microangiopathy, which broadly includes thrombotic thrombocytopaenic purpura (TTP) and haemolytic uraemic syndrome (HUS), is a multisystemic disorder that is characterised by thrombocytopaenia, microangiopathic haemolytic anemia and ischaemic manifestations, resulting from platelet agglutination in the arterial microvasculature. Acral necrosis (distal necrosis of fingers and toes) occurs usually as a sequel to severe Raynaud's phenomenon, a vasculospastic disorder frequently related to endothelial cell dysfunction. We report a case of quinine induced TTP-HUS and acral necrosis, two distinct clinical abnormalities which have not yet been reported together in association with quinine. Both of these conditions in this case resolved promptly to treatment with corticosteroids.

Publication types

  • Case Reports

MeSH terms

  • Adrenal Cortex Hormones / administration & dosage
  • Aged
  • Biopsy, Needle
  • Follow-Up Studies
  • Hemolytic-Uremic Syndrome / chemically induced*
  • Hemolytic-Uremic Syndrome / complications*
  • Hemolytic-Uremic Syndrome / drug therapy
  • Hemolytic-Uremic Syndrome / pathology
  • Humans
  • Immunohistochemistry
  • Male
  • Necrosis
  • Purpura, Thrombotic Thrombocytopenic / chemically induced*
  • Purpura, Thrombotic Thrombocytopenic / complications*
  • Purpura, Thrombotic Thrombocytopenic / drug therapy
  • Purpura, Thrombotic Thrombocytopenic / pathology
  • Quinine / administration & dosage
  • Quinine / adverse effects*
  • Risk Assessment
  • Toes / pathology
  • Treatment Outcome

Substances

  • Adrenal Cortex Hormones
  • Quinine