FDA Poisonous Plant Database
AUTHOR(S): Bradley, R.; Harchelroad, F.
TITLE: Root beer as a cause for thrombocytopenia.
YEAR: 1994 CITATION: Vet Hum Toxicol, 36(4), 357 [English]
FDA #: F12906
ABSTRACT: Abstract: (no other info in this issue) Background: Drugs are a known cause of thrombocytopenia, with quinine numbering amongst the causative agents. We present a case whereby quillaia, a root beer foaming agent, can also be implicated. Case Report: A 66-year-old white male with past medical history of hypertension, atherosclerotic coronary vascular disease, asthma, nasal polyps and a seizure disorder was admitted with petechiae, nose bleeds, and a platelet count of 1000/cL. He was treated with intravenous immunoglobulin (IVIG) and steroids, and his platelets increased back to normal levels. The precipitating factor was thought to be quinine, as he reported having tried to lose weight through drinking less sugary soft drinks, and had for the first time in his life, drank quinine containing tonic water approximately 7 days prior to admission. Anti-platelet antibodies subsequently proved positive. Three weeks later, her[sic][he] returned with similar symptoms and a markedly low platelet count. He had drank QV Root BeerTM containing quillaia prior to the onset of symptoms but no tonic water. Further history found that he had been drinking the quillaia containing root beer prior to the initial episode. Once again, IVIG and steroids were administered, and he recovered. Discussion: Quillaia is a South American tree bark extract as is quinine. Quillaic acid forms a saponin when combined with sugar, and is thus useful as a foaming agent. Quillaia saponins have also been shown to boost humoral immune responses in mice when given with rabies vaccine. We postulate that quillaia might be a potential cause of thrombocytopenia, as there was no other apparent etiology in the patient, and because of quillaia¿s reported toxicities and immune system interactions. Conclusion: Quillaia, used as a foaming agent in QV Root Beer,TM may be implicated in this case of thrombocytopenia.
GRIN #: 30776
COMMON NAME: quillaia
STANDARD COMMON NAME: quillaja
STANDARD PLANT NAME: Quillaja saponaria Molina