Fatal antimalarial-induced cardiomyopathy: Report of 2 cases

Morteza Azimian, Sakir Gultekin, Jessica L. Hata, James B. Atkinson, Kim A. Ely, Howard A. Fuchs, Bret C. Mobley

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Abstract

Chloroquine and hydroxychloroquine are used to chronically treat certain rheumatologic diseases and are generally considered safe. We describe 2 patients with skeletal myopathy and fatal cardiomyopathy-uncommon and underrecognized adverse effects of these agents. Both patients developed arrhythmias and heart failure, and 1 patient had documented diaphragmatic involvement. Muscle specimens showed typical vacuolar myopathy (indicative of impaired autophagy) with myeloid bodies in both patients and curvilinear bodies in 1 patient. Antimalarial-induced cardiomyopathy should be considered in patients receiving these medications with otherwise unexplained muscle weakness or cardiac symptoms. Whether autophagy enhancers can be used to manage such myopathies merits investigation.

Original languageEnglish (US)
Pages (from-to)363-366
Number of pages4
JournalJournal of Clinical Rheumatology
Volume18
Issue number7
DOIs
Publication statusPublished - Oct 2012

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Keywords

  • autophagy
  • cardiomyopathy
  • hydroxychloroquine
  • myopathy

ASJC Scopus subject areas

  • Rheumatology

Cite this

Azimian, M., Gultekin, S., Hata, J. L., Atkinson, J. B., Ely, K. A., Fuchs, H. A., & Mobley, B. C. (2012). Fatal antimalarial-induced cardiomyopathy: Report of 2 cases. Journal of Clinical Rheumatology, 18(7), 363-366. https://doi.org/10.1097/RHU.0b013e31826852db