Quinidine hypersensitivity: a side effect of a forgotten antiarrhythmic

Quinidine is one of the oldest antiarrhythmics known. Over the years, its use has decreased along with its side effects. Our case describes a 69-year-old woman with recurrent resistant ventricular tachycardia on Quinidine and Amiodarone who presented with acute liver toxicity. Drug-induced liver tox...

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Bibliographic Details
Published in:BMJ case reports 2020-08, Vol.13 (8), p.e235528
Main Authors: El-khatib, Layan, Alrayes, Hussayn, Sallam, Omar, Elbanna, Ahmed
Format: Article
Language:English
Subjects:
Abdomen
Acute Disease
Aged
Amiodarone - therapeutic use
Anti-Arrhythmia Agents - adverse effects
Anti-Arrhythmia Agents - therapeutic use
Antiarrhythmics
Bile
Case reports
Chemical and Drug Induced Liver Injury - diagnosis
Chemical and Drug Induced Liver Injury - etiology
Cholecystectomy
Drug administration
Drug Hypersensitivity - diagnosis
FDA approval
Female
Fever
Granulomas
Hepatitis
Humans
Liver
Liver diseases
Nausea
Patients
Phosphatase
Quinidine - adverse effects
Quinidine - therapeutic use
Tachycardia, Ventricular - drug therapy
Unexpected Outcome (Positive or Negative) Including Adverse Drug Reactions
Vomiting
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Summary:Quinidine is one of the oldest antiarrhythmics known. Over the years, its use has decreased along with its side effects. Our case describes a 69-year-old woman with recurrent resistant ventricular tachycardia on Quinidine and Amiodarone who presented with acute liver toxicity. Drug-induced liver toxicity was at the top of our differential diagnosis list. Taking multiple factors into consideration, a decision was made to discontinue Quinidine, the patient’s symptoms and lab abnormalities resolved within 1 week, yielding the diagnosis of Quinidine hypersensitivity.
ISSN:1757-790X
1757-790X
DOI:10.1136/bcr-2020-235528