Toxic hydroxychloroquine-induced cardiomyopathy complicating systemic lupus treatment
Copyright © 2020 Elsevier Masson SAS. All rights reserved..
Hydroxychloroquine (HCQ) is considered as efficient and safe to treat systemic lupus. We report a case of fatal toxic cardiomyopathy, an underrecognized adverse effect of HCQ. A 72-year-old woman with systemic lupus erythematosus treated for 24 years by HCQ received a kidney allograft. One year later she developed a cardiomyopathy with conductive disorders. An endomyocardial biopsy showed severe non-specific myocardial fibrosis and hypertrophic vacuolated myocytes. Transmission electron microscopy showed curvilinear bodies and pseudomyelin figures consistent with HCQ-induced cardiomyopathy. At immunohistochemistry LC3b, p62 and beclin-1 accumulated in vacuolated cardiac myocytes suggesting impaired cell autophagy. When unexplained cardiac disease develops in patients receiving long-term HCQ treatment, toxic cardiomyopathy should be considered leading to a diagnostic endomyocardial biopsy.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2021 |
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| Erschienen: |
2021 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:41 |
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| Enthalten in: |
Annales de pathologie - 41(2021), 1 vom: 01. Feb., Seite 101-104 |
| Sprache: |
Französisch |
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| Weiterer Titel: |
Cardiomyopathie toxique induite par l’hydroxychloroquine compliquant le traitement d’un lupus systémique |
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| Beteiligte Personen: |
Bories, Marie-Cécile [VerfasserIn] |
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| Links: |
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| Anmerkungen: |
Date Completed 15.10.2021 Date Revised 15.10.2021 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.annpat.2020.09.007 |
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| funding: |
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| PPN (Katalog-ID): |
NLM319832023 |
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| 520 | |a Hydroxychloroquine (HCQ) is considered as efficient and safe to treat systemic lupus. We report a case of fatal toxic cardiomyopathy, an underrecognized adverse effect of HCQ. A 72-year-old woman with systemic lupus erythematosus treated for 24 years by HCQ received a kidney allograft. One year later she developed a cardiomyopathy with conductive disorders. An endomyocardial biopsy showed severe non-specific myocardial fibrosis and hypertrophic vacuolated myocytes. Transmission electron microscopy showed curvilinear bodies and pseudomyelin figures consistent with HCQ-induced cardiomyopathy. At immunohistochemistry LC3b, p62 and beclin-1 accumulated in vacuolated cardiac myocytes suggesting impaired cell autophagy. When unexplained cardiac disease develops in patients receiving long-term HCQ treatment, toxic cardiomyopathy should be considered leading to a diagnostic endomyocardial biopsy | ||
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| 650 | 4 | |a Lupus systémique | |
| 650 | 4 | |a Systemic lupus erythematosus | |
| 650 | 4 | |a Toxic hydroxychloroquine-induced cardiomyopathy | |
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