This wasn't your usual hangover. A single sip of a vodka tonic at an office party led to seven years (and counting) of kidney problems for one woman. The cocktail sent the 35-year-old to the emergency room with a mysterious affliction. It would be days before doctors realized the source of her illness was quinine-induced thrombotic microangiopathy (TMA) caused by the tonic water in her drink. Dr. James George, the lead author of a case report published Wednesday in the New England Journal of Medicine, tells Live Science the doctors were initially baffled by the affliction, which "hit like lighting." After the 2009 party, the woman suffered cramps, chills, nausea, and a fever. After three days of being unable to urinate, tests showed kidney damage and it appeared TMA was the cause.
But the usual sources of TMA, which happens when blood clots form in one's capillaries, were not there. Then the woman remembered the cocktail, and falling ill 16 months prior after sipping a vodka tonic. Quinine-induced TMA is rare: A 2015 report on her case in Blood explained a search for patients sickened by quinine turned up just 118. In these infrequent cases, quinine triggers an auto-antibody in the blood that attacks the body. Even after the quinine is gone, the damage remains. George says his patient underwent kidney dialysis for two months, and the Blood report described her as experiencing hypertension, fatigue, joint pain, and Stage 3A chronic kidney disease five years later. She continues to take kidney meds. (Quinine made this list of 11 anti-aphrodisiac foods.)