Drug-induced thrombotic microangiopathy: a systematic review of published reports

Al-Nouri, Zayd L.; Reese, Jessica; Terrell, Deirdra R.; Vesely, Sara K.; George, James N.

doi:10.1182/blood-2014-11-611335

Cited by 301 publications

(301 citation statements)

References 11 publications

Supporting

Mentioning

296

Contrasting

Unclassified

Order By: Relevance

“…The diversity of these unexpected additional disorders often caused diagnostic uncertainty and also may have obscured the quinine etiology. The sources of quinine were also diverse [3]. These were not only "drug-induced" disorders; they were also caused by common quinine-containing beverages.…”

Section: Introductionmentioning

confidence: 99%

“…Among the reports of quinine-induced TMA that we previously reviewed [3], many additional disorders were described in addition to the characteristic disorders of TMA (microangiopathic hemolytic anemia, thrombocytopenia, and acute kidney injury). They included chills, fever, and hypotension, neutropenia, disseminated intravascular coagulation (DIC), painful acral cyanosis, liver toxicity, respiratory failure, rhabdomyolysis, and systemic cutaneous reactions.…”

Section: Introductionmentioning

confidence: 99%

“…In our previous systematic reviews of published reports of drug-induced thrombocytopenia (DITP) and of drug-induced thrombotic microangiopathy (DITMA), quinine was the second most common cause of DITP, following only quinidine [1,2], and the most common cause of DITMA, including reports describing TMA as thrombotic thrombocytopenic purpura (TTP) or hemolytic uremic syndrome (HUS) [2,3]. Quinine is also the most common cause of DITMA in the experience of the Oklahoma TTP-HUS Registry and the BloodCenter of Wisconsin [4].…”

Section: Introductionmentioning

confidence: 99%

“…to confirm the level of evidence. For reports of individual patients with immune-mediated reactions, evidence levels were determined using both the Oklahoma criteria [1,3] and the Naranjo criteria, an established and widely used algorithm [10]. For patients with toxic reactions, different criteria were used for determining levels of evidence.…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Diversity and severity of adverse reactions to quinine: A systematic review

et al. 2016

Self Cite

View full text Add to dashboard Cite

Quinine is a common cause of drug-induced thrombocytopenia and the most common cause of druginduced thrombotic microangiopathy. Other quinine-induced systemic disorders have been described. To understand the complete clinical spectrum of adverse reactions to quinine we searched 11 databases for articles that provided sufficient data to allow evaluation of levels of evidence supporting a causal association with quinine. Three reviewers independently determined the levels of evidence, including both immune-mediated and toxic adverse reactions. The principal focus of this review was on acute, immunemediated reactions. The source of quinine exposure, the involved organ systems, the severity of the adverse reactions, and patient outcomes were documented. One hundred-fourteen articles described 142 patients with definite or probable evidence for a causal association of quinine with acute, immune-mediated reactions. These reactions included chills, fever, hypotension, painful acral cyanosis, disseminated intravascular coagulation, hemolytic anemia, thrombocytopenia, neutropenia, acute kidney injury, rhabdomyolysis, liver toxicity, cardiac ischemia, respiratory failure, hypoglycemia, blindness, and toxic epidermal necrolysis. One hundred-two (72%) reactions were caused by quinine pills; 28 (20%) by quinine-containing beverages; 12 (8%) by five other types of exposures. Excluding 41 patients who had only dermatologic reactions, 92 (91%) of 101 patients had required hospitalization for severe illness; 30 required renal replacement therapy; three died. Quinine, even with only minute exposure from common beverages, can cause severe adverse reactions involving multiple organ systems. In patients with acute, multi-system disorders of unknown origin, an adverse reaction to quinine should be considered.

show abstract

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Diversity and severity of adverse reactions to quinine: A systematic review

et al. 2016

Self Cite

View full text Add to dashboard Cite

show abstract

“…It is characterised by new onset hypertension, proteinuria and kidney injury in association with the drug history. 4,5 Two different mechanisms have been proposed: immune-mediated reactions and direct, toxic effects of the drug. Immune mediated DiTMA was fi rst recognised in a patient with repeated episodes of acute kidney injury, haemolysis and thrombocytopaenia with use of quinine.…”

Section: Discussionmentioning

confidence: 99%

Drug Induced Thrombotic Microangiopathy Caused by Levofloxacin

Kazi

Preston

2018

Journal of the Royal College of Physicians of Edinburgh

View full text Add to dashboard Cite

Thrombotic microangiopathy is a rare but serious manifestation of a variety of diseases. The key features are microangiopathic haemolysis, thrombocytopaenia, renal dysfunction and neurological symptoms. Here we discuss the case of a previously well male presenting with communityacquired pneumonia who developed thrombotic microangiopathy during admission. This case illustrates the dif culties in the differential diagnosis and reminds us of the importance of the peripheral blood lm in identifying the cause of thrombocytopaenia. One life-threatening cause of thrombotic microangiopathy is thrombotic thrombocytopaenia purpura and when that diagnosis is suspected emergency plasma exchange is essential. Many drugs can cause thrombotic microangiopathy and here we highlight the commonly-prescribed antibiotic levo oxacin as the culprit.Keywords: levofl oxacin, pneumonia, red cell fragments, thrombocytopenia, thrombotic microangiopathy Declaration of interests: No confl ict of interests declaredAbstract Introduction

show abstract