Abstract: OBJECTIVE: To
report a case of quinine-induced hepatotoxicity presenting
within 24 hours following the ingestion of the first dose.
DATA SOURCES: Case report
information was obtained from the medical record, the patient,
and the physicians involved in this patient's case. MEDLINE
and Index Medicus were searched to obtain relevant published
literature from January 1942 to May 1997 using the terms
quinine, muscle cramps, liver disease, and hepatotoxicity.
CASE SUMMARY: A 57-year-old
Native American woman presented with symptoms of nausea,
vomiting, generalized myalgia, headache, fever, chills, and
rigor. The alkaline phosphatase, lactate dehydrogenase,
aspartate aminotransferase, alanine aminotransferase, and
gamma-glutamyltranspeptidase concentrations were dramatically
elevated. Quinine was suspected as the cause after several
days of hospitalization and continued therapy. With
discontinuation of the quinine, the patient's symptoms
resolved within 48 hours and the liver enzyme concentrations
declined within 72 hours.
hepatotoxicity has occurred with quinidine, the optical isomer
of quinine. Limited awareness of quinine-induced
hepatotoxicity may result in an unrecognized adverse effect.
AUTHOR: Farver DK, Lavin MN
SOURCE: ANNALS OF PHARMACOTHERAPY 33: (1)