Hydroxychloroquine Myocardial Toxicity in a Patient with Systemic Lupus Erythematosus
  • Pierre Malchair
    Department of Internal Medicine, Bellvitge University Hospital - IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
  • Maria Labori
    Department of Internal Medicine, Bellvitge University Hospital - IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
  • Manuel Rubio-Rivas
    Department of Internal Medicine, Bellvitge University Hospital - IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
  • Joel Salazar-Mendiguchia
    Cardiomyopathy, Heart Failure and Transplantation Unit, Department of Cardiology, Bellvitge University Hospital - IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
  • Nuria Baixeras
    Department of Pathology, Bellvitge University Hospital - IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
  • Xavier Corbella
    Department of Internal Medicine, Bellvitge University Hospital - IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya, Barcelona, Spain

Keywords

Hydorxychloroquine, cardiotoxicity, heart failure, side effect, systemic lupus erythematosus

Abstract

Hydroxychloroquine is an antimalarial drug used in many rheumatologic and systemic diseases. Although considered by clinicians to be relatively safe, serious side effects have been documented (retinotoxicity, neuromyotoxicity and cardiotoxicity).

We present the case of a 41-year-old woman with systemic lupus erythematosus (SLE) who presented at our institution with acute heart failure after taking hydroxychloroquine for a period of 3 months. An endomyocardial biopsy ruled out myocarditis related to systemic lupus erythematosus but demonstrated pathological changes related to hydroxychloroquine toxicity. It is exceptional to observe such cardiac toxicity after such a low cumulative dose (16 grams).

The potential severity and reversibility of this complication underscores the importance of a high level of suspicion and timely diagnosis.

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References

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    Published: 2015-05-05
    Issue: Vol. 2 No. 3 (2015) (view)


    How to cite:
    1.
    Malchair P, Labori M, Rubio-Rivas M, Salazar-Mendiguchia J, Baixeras N, Corbella X. Hydroxychloroquine Myocardial Toxicity in a Patient with Systemic Lupus Erythematosus. EJCRIM 2015;2 doi:10.12890/2015_000204.

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