Woman, 35, suffers severe kidney damage after ONE sip of a vodka tonic – and is STILL recovering 7 years later
The reaction caused damage to her kidneys and seven years later she is still taking medication to keep the organ healthy
IT seemed like an ordinary drink with colleagues, but one sip of a vodka tonic landed a 35-year-old woman in the emergency room with blood clots forming all over her body and kidney damage – and seven years on she is still suffering.
At the time of the reaction, in 2009, the woman told medics she suddenly became ill when she was driving home from an office party.
She said she developed chills, muscle aches, nausea and abdominal cramps and during the night she ran a fever of 38.9 degrees and her stomach pain continued.
The woman had a rare condition called quinine-induced thrombotic microangiopathy, which caused a body-wide reaction to quinine, a chemical found in tonic water.
The illness “hit like lightening” said Dr. James George, a haematologist at the University of Oklahoma and one of the doctors who treated her wrote in
But by the time she went to the emergency room the next day her symptoms had improved and doctors suspected she had the stomach flu.
She returned to accident and emergency two days later as she still had back pain and had not urinated since she became ill, according to the case report.
Further tests in hospital revealed she had suffered kidney damage.
The doctors suspected that the woman had thrombotic microangiopathy (TMA), which occurs when blood clots form in the tiny vessels in the body and can be caused by a range of factors, Dr George said.
But her case wasn’t one that doctors often see, such as E. coli infection or problems with blood clotting.
What is quinine?
Quinine is a basic organic chemical that is found in tonic water and bitter lemon drinks.
It has been used for the treatment of malaria and associated febrile states, leg cramps caused by vascular spasm, internal hemorrhoids, varicose veins, and pleural cavities after thoracoplasty.
As of 2006, it is no longer recommended by the World Health Organisation as first-line treatment for malaria and should only be used when other drugs are not available.
Quinine in some cases can lead to constipation, erectile dysfunction, diarrhea, and/or vivid dreams.
Quinine can also cause drug-induced immune thrombocytopenic purpura – low platelet count – and symptoms can be severe enough to require hospitalisation and platelet transfusion.
Quinine can also cause the clotting condition.
Dr George wrote it was then the woman recalled having a sip of a vodka and tonic at her office party the night she got sick.
She also realised that she had a similar reaction 16 months earlier, when she drank a vodka tonic at a wedding and also had to go to the hospital, according to the report.
That time, however, her major symptom was a severe headache, the doctors wrote.
The woman was the 19th person Dr George had seen with quinine-induced TMA over a 15-year-period, he continued.
The woman spent about a week in the hospital, but during this time, she was not acutely ill, he said.
Because of the damage to her kidneys, she had to undergo dialysis for two months.
At a recent follow-up visit, seven years later, the woman told doctors that she was doing well and was able to fulfill her responsibilities with her family and her career.
But she is still taking medications for her kidneys, and she often has trouble thinking of “particular words during conversations and had to stop in the middle of her sentences to ‘wait for her brain to catch up,'” according to the report.
The damage from the auto-antibodies also might have affected some of the small blood vessels in her brain, Dr George noted.
Currently, there is no specific treatment for quinine-induced TMA.
When a person has quinine-induced TMA, he or she has a particular type of “auto-antibody” in the blood, .
Auto-antibodies, which are found in people with autoimmune disease, attack the body as if it were a “foreign” invader.
They are normally quite dormant in the body, but when the person ingests quinine, the chemical binds to these auto-antibodies and causes them to change their shape and attack other cells in the body.
Then, once the quinine has left the body the cells go back to normal, but the damage to the body remains.
Dr George said: “It’s like a tornado going through town, and then you spend a month cleaning up.”
He said by the time the woman had presented to the emergency room, the quinine had already left her body but that the auto-antibodies had enough time to do severe damage to body, her kidneys in particular.