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Cocktail Purpura

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1967

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Case Studies1 March 1967Cocktail PurpuraAn Unusual Case of Quinine SensitivityGERALD A. BELKIN, M.D.GERALD A. BELKIN, M.D.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-66-3-583 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptThrombocytopenic purpura may follow the administration of a wide variety of drugs (1). With some medications, thrombocytopenia is the result of diminished platelet production secondary to megakaryocytic damage; with others, it is due to massive platelet destruction on an immunologic basis.Thrombocytopenia due to Sedormid®, quinidine, and quinine is clearly of the immunologic variety. These and certain other drugs act as haptenes, combining loosely with platelets to provide the antigenic stimulus. The resultant antibody destroys platelets only in the presence of the offending drug. Withdrawal of the medication, therefore, provides complete recovery.Prompt recognition of this syndrome depends on eliciting...References1. CROSBYKAUFMAN WHRM: Drug-induced blood dyscrasias. IV. Thrombocytopenia. JAMA 189: 417, 1964. CrossrefMedlineGoogle Scholar2. VIPAN WH: Quinine as a cause of purpura. Lancet 2: 37, 1865. CrossrefGoogle Scholar3. LINCOLNSCHMIDT RBHL: Thrombopenic purpura following quinine. Amer. Practit. 3: 43, 1952. Google Scholar4. SCHRAGERKEAN JBH: Purpura as a complication of malaria. Amer. J. Med. Sci. 212: 54, 1946. CrossrefGoogle Scholar5. CREGERHANSWORTH WPJH: Erythrophagocytosis and thrombocytopathy occurring during the course of a Henoch-Schoenlein syndrome due to quinine. Amer. J. Med. 17: 423, 1954. CrossrefMedlineGoogle Scholar6. AYBEYOZKARAKAYA RK: Kinin allerjisine bagli bir trombositopenik purpura vakasi. Tip. Fak. Mec. (Istanbul) 14: 235, 1951. MedlineGoogle Scholar7. 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BOLTON FG: Thrombocytopenic purpura due to quinidine. II. Serologic mechanisms. Blood 11: 547, 1956. CrossrefMedlineGoogle Scholar29. SHULMAN NR: Immunoreactions involving platelets. I. A steric and kinetic model for formation of a complex from a human antibody, quinidine as a haptene, and platelets; and for fixation of complement by the complex. J. Exp. Med. 107: 665, 1958. CrossrefMedlineGoogle Scholar30. SCHENRABINOVITZ RJM: Thrombocytopenic purpura due to quinidine. Brit. Med. J. 2: 1502, 1958. CrossrefMedlineGoogle Scholar31. FREEDMANBRODYBARR ALEAPS: Immunothrombocytopenic purpura due to quinidine; report of four new cases with special observations on patch testing. J. Lab. Clin. Med. 48: 205, 1956. MedlineGoogle Scholar32. BOLTONDAMESHEK FGW: Thrombocytopenic purpura due to quinidine. I. Clinical studies. Blood 11: 527, 1956. CrossrefMedlineGoogle Scholar33. SHULMAN NR: Immunoreactions involving platelets. IV. Studies on the pathogenesis of thrombocytopenia in drug purpura using test doses of quinidine in sensitized individuals; their implications in idiopathic thrombocytopenic purpura. J. Exp. Med. 107: 711, 1958. CrossrefMedlineGoogle Scholar34. DAWSONGARBADE WTFA: Idiosyncrasy to quinine, cinchonidine, and ethylhydrocupreine. JAMA 94: 704, 1930. CrossrefGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Los Angeles, CaliforniaFrom the Cedars-Sinai Medical Research Institute, and the Departments of Medicine, Cedars-Sinai Medical Center and the UCLA Center for the Health Sciences, Los Angeles, Calif.Requests for reprints should be addressed to Gerald A. Belkin, M.D., 6221 Wilshire Blvd., Los Angeles, Calif. 90048. 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REID, M.D., N. RAPHAEL SHULMAN, M.D.Hypersensitivity reactions to food additivesThrombocytopenia induced by quinineAntifungal, Anthelmintic, and Antiprotozoal DrugsIntolerance to Food and Drug AdditivesDrug-induced immune thrombocytopeniaIntravascular Coagulation Induced by QuinineHeroin-induced thrombocytopenic purpuraHeparin-related immune thrombocytopeniaAllergien durch Begleit- und Zusatzstoffe in Nahrungsund GenußmittelnCutaneous reactions to food and drug additivesQuinine Fatality—Case ReportPossible Improved Technique of Skin Patch TestingPlatelet Transfusion for Quinidine-Induced ThrombocytopeniaÆTIOLOGICAL ASPECTS OF THE SCHIZOPHRENIA–LIKE PSYCHOSIS OF TEMPORAL–LOBE EPILEPSY 1 March 1967Volume 66, Issue 3Page: 583-586KeywordsAntigensBlistersDrug administrationDrugsPlateletsQuinineSpecificity Issue Published: 1 March 1967 PDF downloadLoading ...

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