Abstract
Every drug comes with some side effect. It is the benefit/risk ratio that determines the medical use of the drug. Quinine, a known antimalarial drug, has been used for nocturnal leg cramps since the 1930s; it is associated with severe life-threatening hematological and cardiovascular side effects. Disseminated intravascular coagulation (DIC), albeit rare, is a known coagulopathy associated with Quinine. It is imperative to inquire about the Quinine intake in medication history in patients with coagulopathy, as most patients still consider it a harmless home remedy for nocturnal leg cramps. In this report, we present a case of coagulopathy in a middle-aged woman, who gave a history of taking Quinine for nocturnal leg cramps, as her home remedy. Early identification of the offending agent led to the diagnosis, prompt discontinuation of the medication, and complete recovery and prevented the future possibility of recurrence.
Highlights
Quinine has been used widely for idiopathic leg cramps since the 1930s [1, 2]
In the United States, Quinine is a prescription medication, approved by the Food and Drug Administration (FDA), solely, to be used for the treatment of uncomplicated malaria, caused by the parasite Plasmodium falciparum, primarily, in travellers returning from the malaria-endemic areas [4]
She was admitted to the hospital, where lab tests showed prolonged prothrombin time (PT), international normalized ratio (INR), activated partial thromboplastin time, and elevated D-dimer level, with a normal platelet count
Summary
Quinine has been used widely for idiopathic leg cramps since the 1930s [1, 2]. It has been implicated in some grave and life-threatening adverse events, such as thrombocytopenia, hypersensitivity reaction, and prolonged QT interval on electrocardiography [3]. In the United States, Quinine is a prescription medication, approved by the Food and Drug Administration (FDA), solely, to be used for the treatment of uncomplicated malaria, caused by the parasite Plasmodium falciparum, primarily, in travellers returning from the malaria-endemic areas [4]. The serious adverse effects may still continue to be reported [3] In this corresponding study, we are reporting a case of a 45-year-old woman, who developed disseminated intravascular coagulation (DIC), after taking Quinine pills for night cramps
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