TY - JOUR T1 - Case Report and Literature Review: Quinacrine-induced Cholestatic Hepatitis in Undifferentiated Connective Tissue Disease JF - The Journal of Rheumatology JO - J Rheumatol SP - 1354 LP - 1355 DO - 10.3899/jrheum.150050 VL - 42 IS - 7 AU - RAJAIE NAMAS AU - APRIL MARQUARDT Y1 - 2015/07/01 UR - http://www.jrheum.org/content/42/7/1354.abstract N2 - To the Editor:A 45-year-old African American woman presented to the rheumatology clinic with a history of undifferentiated connective tissue disease (UCTD), manifesting as biopsy-proven urticarial dermatitis, inflammatory arthritis, fatigue, and weight loss in the setting of positive immunofluorescence antinuclear antibodies (1:160, speckled pattern), anti-RNP, anti-Sm/RNP, and antichromatin antibodies. She started treatment with quinacrine 100 mg per day for her disease. Quinacrine was chosen because she developed a pruritic rash after taking hydroxychloroquine for 2 months. At the time she started treatment with quinacrine, she was also receiving 5 mg of prednisone, diphenhydramine as needed, ergocalciferol, and norgestimate-ethinyl estradiol. All of these were longterm medications.Four weeks after starting quinacrine, she presented to the emergency department with generalized fatigue, loss of appetite, nausea, diffuse abdominal pain, scleral icterus, and dark tea-colored urine. She reported no history of new medications, supplements, or alcohol intake. Laboratory investigations demonstrated … Address correspondence to Dr. R. Namas, Department of Internal Medicine, Division of Rheumatology, University of Michigan, Ann Arbor, Michigan 48109, USA. E-mail: rnamas{at}med.umich.edu ER -