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
DOI: https://doi.org/10.12890/2015_000204

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.

Author Biographies

Pierre Malchair ,
Department of Internal Medicine, Bellvitge University Hospital - IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain

MD,

1 Department of Internal Medicine,BellvitgeUniversityHospital - IDIBELL, L'Hospitalet de Llobregat,Barcelona,Spain

Maria Labori ,
Department of Internal Medicine, Bellvitge University Hospital - IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain

MD,

1 Department of Internal Medicine,BellvitgeUniversityHospital - IDIBELL, L'Hospitalet de Llobregat,Barcelona,Spain

Manuel Rubio-Rivas ,
Department of Internal Medicine, Bellvitge University Hospital - IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain MD, PhD
1 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

MD,

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

MD

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 MD, PhD, MBA1

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References

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Published: 2015-05-05

Issue: Vol. 2 No. 3 (2015) (view)

Section: Articles

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.