Quinine-Induced Blindness Reversed by an Increase in α<sub>1</sub>-Acid Glycoprotein Level
Authors: Giovanni Di Perri, Benedetta Allegranzi, Stefano Bonora
Journal: Annals of Internal Medicine (2002)

Letters19 February 2002Quinine-Induced Blindness Reversed by an Increase in α1-Acid Glycoprotein LevelGiovanni Di Perri, MD, DTM&H, PhD, Benedetta Allegranzi, MD, DTM&H, and Stefano Bonora, MDGiovanni Di Perri, MD, DTM&H, PhDUniversity of Torino; 10149 Torino, ItalyUniversity of Verona; 37126 Verona, ItalyUniversity of Torino; 10149 Torino, ItalySearch for more papers by this author, Benedetta Allegranzi, MD, DTM&HUniversity of Torino; 10149 Torino, ItalyUniversity of Verona; 37126 Verona, ItalyUniversity of Torino; 10149 Torino, ItalySearch for more papers by this author, and Stefano Bonora, MDUniversity of Torino; 10149 Torino, ItalyUniversity of Verona; 37126 Verona, ItalyUniversity of Torino; 10149 Torino, ItalySearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-136-4-200202190-00016 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:In patients who have malaria and are receiving quinine treatment, blindness is an exceedingly rare event (<1 in 500 cases) whose pathogenesis is unclear (1). Since blindness has been more frequently associated with a total quinine intake of 4 g or greater, a concentration-dependent relationship seems plausible (2). We report the resolution of quinine-induced blindness in a patient with malaria whose total plasma quinine concentration at the start of recovery was unexpectedly higher than that measured when complete blindness was present.A 43-year-old Ghanaian man residing in Italy presented with a mild malaria attack (9000 Plasmodium falciparum ...References1. Krishna S, White NJ. Pharmacokinetics of quinine, chloroquine and amodiaquine. Clinical implications. Clin Pharmacokinet. 1996;30:263-99. [PMID: 8983859] CrossrefMedlineGoogle Scholar2. Boland ME, Roper SM, Henry JA. Complications of quinine poisoning. Lancet. 1985;1:384-5. [PMID: 2857431] CrossrefMedlineGoogle Scholar3. Pukrittayakamee S, Looareesuwan S, Keeratithakul D, Davis TM, Teja-Isavadharm P, Nagachinta B, et al . A study of the factors affecting the metabolic clearance of quinine in malaria. Eur J Clin Pharmacol. 1997;52:487-93. [PMID: 9342585] CrossrefMedlineGoogle Scholar4. Silamut K, White NJ, Looareesuwan S, Warrell DA. Binding of quinine to plasma proteins in falciparum malaria. Am J Trop Med Hyg. 1985;34:681-6. [PMID: 3896000] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Giovanni Di Perri, MD, DTM&H, PhD; Benedetta Allegranzi, MD, DTM&H; Stefano Bonora, MDAffiliations: University of Torino; 10149 Torino, ItalyUniversity of Verona; 37126 Verona, ItalyUniversity of Torino; 10149 Torino, Italy PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byQuinineANTIPROTOZOAL AND ANTIHELMINTHIC DRUGSQuinineAntiprotozoal drugsCurrent Awareness: Pharmacoepidemiology and Drug Safety 19 February 2002Volume 136, Issue 4Page: 339KeywordsAttentionBlindnessBlood plasmaDrugsGlycoproteinsMalariaQuinineToxicityVisual acuityVomiting ePublished: 19 February 2002 Issue Published: 19 February 2002 Copyright & PermissionsCopyright © 2002 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...