{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T21:48:24Z","timestamp":1791582504264,"version":"4.3.4"},"reference-count":37,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2016,4,4]],"date-time":"2016-04-04T00:00:00Z","timestamp":1459728000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["American J Hematol"],"published-print":{"date-parts":[[2016,5]]},"abstract":"<jats:p>Quinine is a common cause of drug\u2010induced thrombocytopenia and the most common cause of drug\u2010induced thrombotic microangiopathy. Other quinine\u2010induced systemic disorders have been described. To understand the complete clinical spectrum of adverse reactions to quinine we searched 11 databases for articles that provided sufficient data to allow evaluation of levels of evidence supporting a causal association with quinine. Three reviewers independently determined the levels of evidence, including both immune\u2010mediated and toxic adverse reactions. The principal focus of this review was on acute, immune\u2010mediated reactions. The source of quinine exposure, the involved organ systems, the severity of the adverse reactions, and patient outcomes were documented. One hundred\u2010fourteen articles described 142 patients with definite or probable evidence for a causal association of quinine with acute, immune\u2010mediated reactions. These reactions included chills, fever, hypotension, painful acral cyanosis, disseminated intravascular coagulation, hemolytic anemia, thrombocytopenia, neutropenia, acute kidney injury, rhabdomyolysis, liver toxicity, cardiac ischemia, respiratory failure, hypoglycemia, blindness, and toxic epidermal necrolysis. One hundred\u2010two (72%) reactions were caused by quinine pills; 28 (20%) by quinine\u2010containing beverages; 12 (8%) by five other types of exposures. Excluding 41 patients who had only dermatologic reactions, 92 (91%) of 101 patients had required hospitalization for severe illness; 30 required renal replacement therapy; three died. Quinine, even with only minute exposure from common beverages, can cause severe adverse reactions involving multiple organ systems. In patients with acute, multi\u2010system disorders of unknown origin, an adverse reaction to quinine should be considered. Am. J. Hematol. 91:461\u2013466, 2016. \u00a9 2016 Wiley Periodicals, Inc.<\/jats:p>","DOI":"10.1002\/ajh.24314","type":"journal-article","created":{"date-parts":[[2016,1,29]],"date-time":"2016-01-29T03:27:16Z","timestamp":1454038036000},"page":"461-466","source":"Crossref","is-referenced-by-count":52,"title":["Diversity and severity of adverse reactions to quinine: A systematic review"],"prefix":"10.1002","volume":"91","author":[{"given":"Nathan W.","family":"Liles","sequence":"first","affiliation":[{"name":"Department of Biostatistics and Epidemiology College of Public Health, University of Oklahoma Health Sciences Center Oklahoma"},{"name":"Department of Medicine College of Medicine, University of Oklahoma Health Sciences Center Oklahoma"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Evaren E.","family":"Page","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Epidemiology College of Public Health, University of Oklahoma Health Sciences Center Oklahoma"},{"name":"Department of Medicine College of Medicine, University of Oklahoma Health Sciences Center Oklahoma"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amber L.","family":"Liles","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Epidemiology College of Public Health, University of Oklahoma Health Sciences Center Oklahoma"},{"name":"Department of Medicine College of Medicine, University of Oklahoma Health Sciences Center Oklahoma"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara K.","family":"Vesely","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Epidemiology College of Public Health, University of Oklahoma Health Sciences Center Oklahoma"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gary E.","family":"Raskob","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Epidemiology College of Public Health, University of Oklahoma Health Sciences Center Oklahoma"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James N.","family":"George","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Epidemiology College of Public Health, University of Oklahoma Health Sciences Center Oklahoma"},{"name":"Department of Medicine College of Medicine, University of Oklahoma Health Sciences Center Oklahoma"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2016,4,4]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-129-11_Part_1-199812010-00009"},{"key":"e_1_2_5_3_1","unstructured":"Platelets on the Web. 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