Open Access Peer-reviewed Case Report

Quinine induced thrombotic microangiopathy and thrombocytopenia: A teaching hospital's perspective

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Aaron J. Franke corresponding author
William Paul Skelton IV


Although quinine is an infrequently prescribed drug, with malaria treatment being its only FDA-approved indication, unwitting exposure via beverages (e.g., tonic water), over the counter herbal remedies and illegal recreation drugs still occur. We present a unique case of a female patient who denied any known prior history of quinine exposure, who after being prescribed quinine tablets for restless leg syndrome, developed an immune-related thrombotic microangiopathy with thrombocytopenia and subsequent multi-organ failure. It was later elucidated that her only known potential source of prior quinine exposure was a remote history of crack-cocaine use. The patient survived this rare and severe inflammatory response with recovery of renal function and was able to discontinue dialysis.

Quinine, TMA, drug reaction, DITMA, thrombocytopenia

Article Details

How to Cite
J. Franke, A., & Paul Skelton IV, W. (2019). Quinine induced thrombotic microangiopathy and thrombocytopenia: A teaching hospital’s perspective. Advances in General Practice of Medicine, 2(1), 9-12.


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