Quinine may be associated with immune thrombocytopenic purpura.

Synonym: cocktail purpura


Clinical features:

(1) petechiae and/or purpura

(2) thrombocytopenia

(3) history of exposure to quinine, which is contained in tonic water

(4) antibodies to quinine


The episodes of thrombocytopenia may be recurrent. The diagnosis is aided by finding the quinine exposure.


It is important to exclude other causes of an immune thrombocytopenia.



(1) hemolytic-uremic syndrome

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