Purpura due to Inhaled Quinidine

Abstract

To the Editor. —A 35-year-old woman presented with a 2-month history of easy bruising of her arms and legs. Report of Case. — Physical examination revealed an otherwise healthy-appearing woman with purpuric patches over her arms, legs, and trunk. Purpura was present over the interior aspects of the limbs, as well as areas more easily subject to trauma. The patient denied any history of significant trauma, use of prescription or over-the-counter drugs, or illegal drugs of any kind. Also, she denied using of alcohol or drink mixers, such as quinine water or bitter lemon, any significant past illnesses, or earlier episodes suggestive of a coagulopathy; she had had one vaginal delivery, a tubal ligation, and a tonsillectomy, all without incident. The patient worked for a distributor of pharmaceuticals. Her job involved repackaging bulk supplies of tablets into smaller containers. When asked, she replied that she had been working with quinidine