Quinine-induced thrombocytopenia following intravenous use of heroin

Profound thrombocytopenia developed in a 22-year-old man after intravenous use of heroin. A high-titer, quinine-dependent, platelet-specific antibody was detected in his serum using lysis of normal platelets labeled with chromium 51 and an electroimmunoassay for measurement of platelet-associated Ig...

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Bibliographic Details
Published inArchives of internal medicine (1960) Vol. 143; no. 6; p. 1174
Main Authors Christie, D J, Walker, R H, Kolins, M D, Wilner, F M, Aster, R H
Format Journal Article
LanguageEnglish
Published United States 01.06.1983
Subjects
Adult
Blood Platelets - immunology
Chromium Radioisotopes
Drug Contamination
Heroin - administration & dosage
Heroin - adverse effects
Humans
Immunoassay - methods
Immunoglobulin G - analysis
Injections, Intravenous
Male
Quinine - adverse effects
Quinine - blood
Quinine - immunology
Thrombocytopenia - blood
Thrombocytopenia - chemically induced
Thrombocytopenia - immunology
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Summary:Profound thrombocytopenia developed in a 22-year-old man after intravenous use of heroin. A high-titer, quinine-dependent, platelet-specific antibody was detected in his serum using lysis of normal platelets labeled with chromium 51 and an electroimmunoassay for measurement of platelet-associated IgG. The antibody was specific for quinine and failed to react with platelets in the presence of quinidine hydrochloride or two structural analogues of heroin. Quinine, a common adulterant found in heroin, was detected in the patient's blood and urine. On the basis of these observations, the patient was judged to have quinine-induced immunologic thrombocytopenia. To our knowledge, this report is the first to confirm that quinine used as an adulterant can induce immunologic thrombocytopenia following an injection of heroin.
ISSN:0003-9926
DOI:10.1001/archinte.1983.00350060098016