Crum N F, Gable P
Department of Internal Medicine, Naval Medical Center, San Diego, Calif 92134-5000, USA.
South Med J. 2000 Jul;93(7):726-8.
Quinine is still frequently used by practitioners for the treatment of nocturnal leg cramps, despite the lack of Food and Drug Administration (FDA) approval. We report the 15th case of quinine-induced hemolytic-uremic syndrome (HUS) in the medical literature. The likely mechanism by which quinine induces HUS is via quinine-dependent antibodies to blood cellular constituents. These antibodies likely cause endothelial damage and the resultant nephropathy, microangiopathic hemolytic anemia, and thrombocytopenia that define HUS. Although there is no set guideline for the treatment of quinine-induced HUS, most authorities consider plasmapheresis as the standard of care, especially in severe cases. Our patient required the longest known treatment duration (16 plasmapheresis treatments over a 37-day period) for disease resolution. The prognosis of quinine-induced HUS is excellent, with no deaths reported in the literature.
尽管未获得美国食品药品监督管理局（FDA）的批准，但奎宁仍被从业者频繁用于治疗夜间腿部痉挛。我们报告了医学文献中第15例奎宁诱发的溶血尿毒综合征（HUS）病例。奎宁诱发HUS的可能机制是通过针对血细胞成分的奎宁依赖性抗体。这些抗体可能导致内皮损伤以及由此产生的肾病、微血管病性溶血性贫血和血小板减少，这些都是HUS的特征。虽然对于奎宁诱发的HUS没有既定的治疗指南，但大多数权威人士认为血浆置换是标准治疗方法，尤其是在严重病例中。我们的患者疾病缓解所需的治疗持续时间是已知最长的（在37天内进行了16次血浆置换治疗）。奎宁诱发的HUS预后良好，文献中未报告死亡病例。
