EHS
EHS

Rapid Onset and Resolution of Hydroxychloroquine Cardiomyopathy: A Case Report



Case Reports

. 2022 Sep 26;2022:6503453.


doi: 10.1155/2022/6503453.


eCollection 2022.

Affiliations

Item in Clipboard

Case Reports

Ahmad Ramahi et al.


Case Rep Rheumatol.


.

Abstract

Systemic lupus erythematosus (SLE) is an autoimmune, chronic, and heterogenous disease with organ damage resulting from immune complex deposition and inflammatory infiltrates. Antimalarial drugs, such as hydroxychloroquine (HCQ), are cornerstone immunomodulators for the treatment of SLE. Rarely, HCQ toxicity can occur, leading to devastating outcomes. We report a case of a patient with SLE on HCQ who presented with a rapid onset of large pericardial effusion and a dramatically decreased left ventricular ejection fraction. Endomyocardial biopsy was positive for curvilinear bodies, confirming the diagnosis of hydroxychloroquine cardiotoxicity. Hydroxychloroquine cardiomyopathy is a rare but life-threatening medication side effect. It is important to consider it in any patient taking the medication who presents with a new onset or worsening symptoms of heart failure.

Conflict of interest statement

The authors declare that they have no conflicts of interest.

Figures



Figure 1

(a) Electron microscopic image of endomyocardial biopsy, 12k magnification, demonstrating elongated enlarged mitochondria (orange arrow), myelin figure (green arrow), and curvilinear body (red arrow). (b) Electron microscopic image of endomyocardial biopsy, 20k magnification, demonstrating myelin figure (yellow arrow).

References

    1. Cosnes A., Cosnes A., Duhaut P., et al. Low blood concentration of hydroxychloroquine in patients with refractory cutaneous lupus erythematosus: a French multicenter prospective study. Archives of Dermatology . 2012;148(4):479–484. doi: 10.1001/archdermatol.2011.2558.



      DOI



      PubMed

    1. An J., Woodward J. J., Sasaki T., Minie M., Elkon K. B. Cutting edge: antimalarial drugs inhibit IFN-β production through blockade of cyclic GMP-AMP synthase-DNA interaction. The Journal of Immunology . 2015;194(9):4089–4093. doi: 10.4049/jimmunol.1402793.



      DOI



      PubMed

    1. Costedoat-Chalumeau N., Dunogué B., Morel N., Le Guern V., Guettrot-Imbert G. Hydroxychloroquine: a multifaceted treatment in lupus. Presse Medicale (Paris, France: 1983) . 2014;43(6 Pt 2):e167–e180. doi: 10.1016/j.lpm.2014.03.007.



      DOI



      PubMed

    1. Durcan L., Petri M. Immunomodulators in SLE: clinical evidence and immunologic actions. Journal of Autoimmunity . 2016;74:73–84. doi: 10.1016/j.jaut.2016.06.010.



      DOI



      PMC



      PubMed

    1. Ponticelli C., Moroni G. Hydroxychloroquine in systemic lupus erythematosus (SLE) Expert Opinion on Drug Safety . 2017;16(3):411–419. doi: 10.1080/14740338.2017.1269168.



      DOI



      PubMed



Source link

EHS
Back to top button