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Quinine‐induced renal failure as a result of rhabdomyolysis, haemolytic uraemic syndrome and disseminated intravascular coagulation
Author(s) -
Lim A. K. H.,
Ho L.,
Levidiotis V.
Publication year - 2006
Publication title -
internal medicine journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.596
H-Index - 70
eISSN - 1445-5994
pISSN - 1444-0903
DOI - 10.1111/j.1445-5994.2006.01104.x
Subject(s) - medicine , rhabdomyolysis , quinine , disseminated intravascular coagulation , atorvastatin , coagulation , hemodialysis , gastroenterology , pharmacology , malaria , immunology
This report describes a case of quinine‐induced acute renal failure as a result of a combination of haemolytic uraemic syndrome and rhabdomyolysis with disseminated intravascular coagulation. The abrupt onset of symptoms occurred after ingestion of 300 mg of quinine along with atorvastatin. The patient recovered with supportive management, suggesting that plasma exchange may not be necessary in this situation. The possibility of a drug interaction contributing to rhabdomyolysis is raised. The proposed mechanism is through quinine inhibition of the cytochrome P450 isoenzyme 3A4, which may increase systemic levels of atorvastatin by reducing its first‐pass metabolism.