Quinine hepatotoxicity. An underrecognized or rare phenomenon?

Punukollu, R. C.

doi:10.1001/archinte.150.5.1112

Cited by 7 publications

(5 citation statements)

References 6 publications

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“…The patient recovered within three days. Another patient was rechallenged by Punukollu et al 15 with one dose of quinine 260 mg. Myalgia, arthralgia, and a temperature of 40.4˚C appeared within hours. Liver enzyme concentrations rose within the next 48 hours.…”

Section: Discussionmentioning

confidence: 99%

“…Our patient is consistent with the previous reports with regard to presenting symptoms and significantly elevated liver enzyme concentrations; however, one major difference is that this patient exhibited these manifestations within 24 hours of taking the first dose of quinine as compared to two or more weeks of continued use of quinine indicated in other case reports. [14][15][16][17] Due to the acuteness of presentation and her medical history, an infectious process was postulated. As laboratory and radiologic tests were reported as negative, the postulated diagnosis of bacterial pneumonia was revised in light of the patient's continued increase in liver enzyme concentrations.…”

Section: Discussionmentioning

confidence: 99%

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Quinine-Induced Hepatotoxicity

Farver

Lavin

1999

Ann Pharmacother

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Quinine-Induced Hepatotoxicity

Farver

Lavin

1999

Ann Pharmacother

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“…The number of potential cases of the same pathological condition of quinine-induced hepatotoxicity would be increased if cases without liver biopsy were included [20,21]. Most such cases presented with nonspecific symptoms such as fever, malaise, nausea, arthralgia, and myalgia.…”

Section: Discussionmentioning

confidence: 99%

A case of acute interstitial nephritis and granulomatous hepatitis induced by ingesting quinine

et al. 2014

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Quinine is used for the treatment of malarial infection, though not in common use. It is especially valuable for the parenteral treatment of severe illness owing to drug-resistant strains of Plasmodium falciparum. Quinine is also known to occasionally cause acute renal failure (ARF). Although quinine is listed in some reviews as a cause of acute interstitial nephritis, most cases of quinine-associated acute renal failure have been attributed to the hemolytic-uremic syndrome (HUS). Only two cases of acute renal failure due to acute interstitial nephritis associated with quinine have been reported [1,2]. To our knowledge, there have been 6 reported cases of quinineinduced hepatic granuloma [3][4][5][6][7][8]. We report a case of quinine-induced acute interstitial nephritis (AIN) along with granulomatous hepatitis, both of which were confirmed on biopsy. A 50-year-old Nigerian man was admitted to the hospital with complaints of fever and general fatigue. He had been prescribed quinine as an antimalarial drug in a Nigerian hospital. The patient was febrile and showed nonoliguric ARF and liver dysfunction. In this case, liver injury showed gradual and spontaneous resolution after discontinuing quinine, and ARF resolved after treatment with oral prednisolone.

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“…D uring th e tre a tm e n t period, participants were randomly assigned 300 mg daily dose of hydroquinine hydrobromide dihydrate (54 participants) or placebo (58). The frequency, severity (1)(2)(3)(4)(5)(6)(7)(8)(9)(10), duration, and location of muscle cramps, as well as any side-effects, were recorded by participants in daily diaries. The primary outcome measures were the number of muscle cramps and the number of days during which the participants had muscle cramps (cramp-days).…”

Section: Discussionmentioning

confidence: 99%

Randomised controlled trial of hydroquinine in muscle cramps

Jansen

Veenhuizen²,

Wesseling³

et al. 1997

The Lancet

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of the risk of gynaecomastia associated with cimetidine, omeprazole and other antiulccr medications. BM J 1994; 308: 503-06. Jick H, Jick SS, Gurewich V, Myers MW, Vasilakis C. Risk of idiopathic cardiovascular death and nonfatal venous thromboembolism in women using oral contraceptives with differing progestagen components. Lancet 1995; 346: 1589-93. Methods This randomised, double-blind, placebo-controlled, parallel-group trial consisted of three consecutive 2-week periods: qualification, treatment, and washout. 68 women and 44 men who had at least three muscie cramps per week w ere e n ro lle d . D uring th e tre a tm e n t period, participants were randomly assigned 300 mg daily dose of hydroquinine hydrobromide dihydrate (54 participants) or placebo (58). The frequency, severity (1-10), duration, and location of muscle cramps, as well as any side-effects, were recorded by participants in daily diaries. The primary outcome measures were the number of muscle cramps and the number of days during which the participants had muscle cramps (cramp-days).Findings We excluded five participants from both groups from the analysis. Thus, data from 49 hydroqulnine-group p a rticip a n ts and 53 placebo-group p a rtic ip a n ts were analysed. In both groups the to ta l number of muscle cramps and the number of cramp-days decreased during the tre a tm e n t period compared w ith the qualification period. However, these improvements were greater in the hydroquinine group th a n in th e placebo group. The Correspondence to: Prof A L M Verbeek hydroquinine-group participants reported a median of 8 (95% Cl 7-12) fewer cramps and median of 3 (1-4) fewer cramp-days, whereas those on placebo reported only 3 (0-5) fewer cramps and 1 (0-5) fewer cramp-days. 32 (65%) of participants in the hydroquinine group had a 50% or greater reduction in the number of muscle cramps. After the onset of cramps, hydroquinine did not reduce the severity or duration of cramps. We also found a sustained effect after treatment had stopped. Hydroquinine was well tolerated, and resulted in only mild side-effects. InterpretationIn our study, 300 mg hydroquinine was safe to take in the short-term and significantly more effective than placebo in the prevention of frequent, ordinary muscle cramps. This therapeutic effect outlasted the duration of treatment.

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Quinine hepatotoxicity. An underrecognized or rare phenomenon?

Cited by 7 publications

References 6 publications

Quinine-Induced Hepatotoxicity

Quinine-Induced Hepatotoxicity

A case of acute interstitial nephritis and granulomatous hepatitis induced by ingesting quinine

Randomised controlled trial of hydroquinine in muscle cramps

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