Fatal Hemoglobinuria With Uremia From Quinine in Early Pregnancy

As it is not generally known to the physician that quinine, when employed in early pregnancy, may produce hemoglobinemia with severe kidney damage, we report a case of fatal quinine poisoning in a woman in the early stage of pregnancy, with hemoglobinuria and uremia. The case also stresses the importance of a thorough pathologic and toxicologic examination in any instance in which the clinical observations are not fully explained by the laboratory data. The urea nitrogen retention in the blood of this patient was the highest ever recorded in our laboratories. This, together with increasing oliguria, focused the clinical attention on the kidneys. Since mercury poisoning was ruled out by the analysis of the urine and a history of drug ingestion could not be obtained before the death of the patient, it remained for the postmortem examination to determine the nature and etiology of the anticipated severe renal damage. Here