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The children returned to normal within 2 weeks. Hypoglycemia was reported in a fatal chloroquine intoxication in a year-old black Zambian male. Hypoglycemia has also been seen in patients, especially children, with cerebral malaria. Further studies have shown that the hypoglycemia in these African children was usually present before the antimalarial drugs had been started; in a study in Gambia hypoglycemia occurred after treatment with the drug had been started, although it was not necessarily connected with the treatment.
Convulsions were more common in hypoglycemic children. This commonly unrecognized complication contributes to morbidity and mortality in cerebral Plasmodium falciparum malaria. Hypoglycemia is amenable to treatment with intravenous dextrose or glucose, which may help to prevent brain damage. Although hydroxychloroquine has been used to treat porphyria cutanea tarda, there are reports that it can also worsen porphyria. Plasma potassium varied directly with the systolic blood pressure and inversely with the QRS and QT intervals. Plasma potassium varied inversely with the blood chloroquine. Chloroquine inhibits myelopoiesis in vitro at therapeutic concentrations and higher.
In a special test procedure, a short-lasting anti-aggregating effect could be seen with chloroquine concentrations of 3. These effects have clinical consequences. Chloroquine and related aminoquinolines have reportedly caused blood dyscrasias at antimalarial doses.
Leukopenia, agranulocytosis, and the occasional case of thrombocytopenia have been reported. There is some evidence that myelosuppression is dose-dependent. This is in line with the hypothesis that 4-aminoquinoline therapy merely accentuates the cytopenia linked to other forms of bone marrow damage. Some studies have pointed to inhibitory effects of chloroquine on platelet aggregability.
In an investigation, this aspect of chloroquine was studied in vitro in a medium containing ADP, collagen, and ristocetin. There was a highly significant effect at chloroquine concentrations of 3. However, there were no significant differences in platelet responses to ADP or collagen 2 or 6 hours after adding chloroquine, compared with pre-drug values.
The investigators believed that these data provided no cause for concern in using chloroquine for malaria prophylaxis in patients with impaired hemostasis. Pigmentation of the palate can occur as a part of a more generalized pigmentation in patients taking chloroquine.
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Several patients seen with chloroquine retinopathy in Accra have been observed to present with depigmented patches in the skin of the face. This may be associated with a greyish pigmentation of the mucosa of the hard palate.