Quinine-induced hemolytic uremic syndrome

Clin Nephrol. 1997 Jun;47(6):397-400.


Although quinine use is very common, hemolytic uremic syndrome (HUS) following exposure to quinine is only a recently reported phenomenon, with the first description published in 1991. Previous reports have concentrated on the nature of the hematological process and in particular characterization of the quinine-induced antibodies involved. We present a case of HUS with a clear temporal and immunological relationship to quinine which demonstrates the pathognomonic renal features of HUS. An indirect antiglobulin test with the patient's serum agglutinated red blood cells only in the presence of quinine. Renal biopsy features included glomerular and arteriolar endothelial swelling, capillary loop thrombi, mesangiolysis, segmental sclerosis and segmental ischemia. Early empiric treatment with plasma exchange and corticosteroids was instituted and this resulted in recovery of renal function to normal.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Biopsy
  • Female
  • Glucocorticoids / therapeutic use
  • Hemolytic-Uremic Syndrome / chemically induced*
  • Hemolytic-Uremic Syndrome / diagnosis
  • Hemolytic-Uremic Syndrome / therapy
  • Humans
  • Kidney / pathology
  • Middle Aged
  • Muscle Cramp / drug therapy
  • Muscle Relaxants, Central / adverse effects*
  • Muscle Relaxants, Central / therapeutic use
  • Plasma Exchange
  • Prednisolone / therapeutic use
  • Quinine / adverse effects*
  • Quinine / therapeutic use


  • Glucocorticoids
  • Muscle Relaxants, Central
  • Prednisolone
  • Quinine