QUINIDINE PURPURA: REPORT OF SIX CASES

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Abstract
This report deals with 6 cases of thrombocytopenic purpura associated with quinidine administration. All the patients were women. Their ages ranged from 38 to 69 years. Five of the patients had received intermittent quinidine therapy for paroxysmal cardiac arrhythmias. The 6th patient received a single course of quinidine therapy of 3 weeks duration. The peripheral blood and marrow findings were the same as those of idiopathic thrombocytopenic purpura. The idiosyncrasy to quinidine was demonstrated in 5 of the cases by reproducing the thrombocytopenia by administration of a test dose of quinidine or by showing platelet agglutinins in the presence of quinidine with the technic of Weisfuse. It is emphasized that''a test dose of quinidine should not be given to the patient suspected of having quinidine purpura unless in vitro tests for platelet agglutinins in the presence of quinidine are negative. Treatment of quinidine purpura consists primarily of avoiding further administration of quinidine. The quinidine will be rapidly removed from the circulation and platelet counts will usually be restored to normal within 7 days. ACTH, corticosteroids and blood transfusions may be useful as supportive measures in some cases.

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