Quinidine-induced thrombocytopenia successfully treated with plasma exchange

A 66-year-old woman had significant cervical, oral, and gastrointestinal bleeding associated with quindine-induced immune thrombocytopenia. No response to discontinuance of quinidine, high dose steroids, or platelet transfusion was noted after three days of observation. A single plasma exchange induced immediate cessation of bleeding and rapid restoration of a normal platelet count. Plasma exchange would appear to warrant further exploration in the management of drug-induced thrombocytopenia when the offending drug is heavily bound to plasma proteins.