Cocktail Purpura
Authors: GERALD A. BELKIN
Journal: Annals of Internal Medicine (1967)

Case Studies1 March 1967Cocktail PurpuraAn Unusual Case of Quinine SensitivityGERALD A. BELKIN, M.D.GERALD A. BELKIN, M.D.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-66-3-583 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptThrombocytopenic purpura may follow the administration of a wide variety of drugs (1). With some medications, thrombocytopenia is the result of diminished platelet production secondary to megakaryocytic damage; with others, it is due to massive platelet destruction on an immunologic basis.Thrombocytopenia due to Sedormid®, quinidine, and quinine is clearly of the immunologic variety. These and certain other drugs act as haptenes, combining loosely with platelets to provide the antigenic stimulus. The resultant antibody destroys platelets only in the presence of the offending drug. Withdrawal of the medication, therefore, provides complete recovery.Prompt recognition of this syndrome depends on eliciting...References1. CROSBYKAUFMAN WHRM: Drug-induced blood dyscrasias. IV. Thrombocytopenia. JAMA 189: 417, 1964. CrossrefMedlineGoogle Scholar2. VIPAN WH: Quinine as a cause of purpura. Lancet 2: 37, 1865. CrossrefGoogle Scholar3. LINCOLNSCHMIDT RBHL: Thrombopenic purpura following quinine. Amer. Practit. 3: 43, 1952. Google Scholar4. SCHRAGERKEAN JBH: Purpura as a complication of malaria. Amer. J. Med. Sci. 212: 54, 1946. CrossrefGoogle Scholar5. CREGERHANSWORTH WPJH: Erythrophagocytosis and thrombocytopathy occurring during the course of a Henoch-Schoenlein syndrome due to quinine. Amer. J. Med. 17: 423, 1954. CrossrefMedlineGoogle Scholar6. AYBEYOZKARAKAYA RK: Kinin allerjisine bagli bir trombositopenik purpura vakasi. Tip. Fak. Mec. (Istanbul) 14: 235, 1951. MedlineGoogle Scholar7. 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