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Clinical Notes
May 4, 1964

Acute Renal Failure Precipitated by Quinine Sulfate in Early Pregnancy

JAMA. 1964;188(5):464-466. doi:10.1001/jama.1964.03060310064016

ACUTE RENAL FAILURE during pregnancy or immediately postpartum accounts for 20% to 40% of all cases of acute renal failure.1,2 In the majority of these cases, renal failure results from ischemic tubular necrosis following shock precipitated by uterine hemorrhage or massive intravascular hemolysis1,3 following incompatible blood transfusions. Occasionally, bilateral renal cortical necrosis is responsible for the acute renal failure of these patients.1,4

Although rarely reported, quinine sulfate used as an abortifacient, or for some other purpose in the first trimester of pregnancy, may cause massive intravascular hemolysis followed by ischemic tubular necrosis and acute renal failure.5-9 A patient exhibiting acute renal failure following the ingestion of quinine sulfate during the eighth week of pregnancy has been studied. In this patient, uremia was controlled and complete recovery followed intensive medical management which included peritoneal dialysis.

Report of a Case  A 28-year-old Negro female entered the hospital on

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