{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T11:02:37Z","timestamp":1790938957563,"version":"4.1.0"},"reference-count":33,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2009,3,3]],"date-time":"2009-03-03T00:00:00Z","timestamp":1236038400000},"content-version":"vor","delay-in-days":61,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J of Clinical Apheresis"],"published-print":{"date-parts":[[2009,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Thrombocytopenia with or without microangiopathy following quinine is often referred to as quinine \u201chypersensitivity.\u201d When schistocytes are present it is frequently termed \u201cquinine\u2010associated TTP\/HUS.\u201d A severe deficiency of the vWF\u2010cleaving protease, ADAMTS13, is associated with idiopathic TTP. A previous study of patients with \u201cquinine\u2010associated TTP\/HUS\u201d found that ADAMTS13 activities were not abnormal in 12\/12 patients. A retrospective review of TTP patients with quinine\u2010associated thrombotic microangiopathy (TMA) for whom ADAMTS13 was measured before plasma exchange was performed. Six patients were identified. All were females (age range: 43 to 73, mean = 61.7 years) and had taken quinine for leg cramps. Four of the six experienced renal failure requiring dialysis. Five of the patients had D\u2010Dimers levels measured, all were elevated. In four patients the levels were \u226518 times the upper limit of normal. ADAMTS13 was normal in four patients and mildly decreased in two patients. We conclude that while thrombocytopenia and schistocytosis can be seen in quinine\u2010associated TTP\/HUS, the pathophysiology seems to be distinct from that seen in most cases of idiopathic TTP (i.e., severely decreased ADAMTS13 with an inhibitor). We recommend that a TMA in association with quinine be consistently referred to as quinine\u2010associated thrombotic microangiopathy (quinine\u2010TMA) to better distinguish this entity from idiopathic TTP. The use of plasma exchange in quinine\u2010TMA is called into question. J. Clin. Apheresis, 2009. \u00a9 2009 Wiley\u2010Liss, Inc.<\/jats:p>","DOI":"10.1002\/jca.20194","type":"journal-article","created":{"date-parts":[[2009,3,3]],"date-time":"2009-03-03T22:09:58Z","timestamp":1236118198000},"page":"115-119","source":"Crossref","is-referenced-by-count":22,"title":["Is it quinine TTP\/HUS or quinine TMA? 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