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Hydroxychloroquine neuromyotoxicity.

M Stein1, M J Bell, L C Ang

  • 1Department of Medicine, University of Toronto, Ontario, Canada.

The Journal of Rheumatology
|December 29, 2000
PubMed
Summary
This summary is machine-generated.

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Hydroxychloroquine (HCQ) can cause serious neuromyotoxicity, affecting muscles and nerves. Early evaluation is crucial for patients experiencing proximal myopathy or neuropathy during HCQ treatment, especially with kidney issues.

Area of Science:

  • Rheumatology
  • Neurology
  • Toxicology

Background:

  • Hydroxychloroquine (HCQ) is a widely used medication for inflammatory arthritis.
  • Retinal toxicity is the most recognized serious side effect of HCQ.
  • Neuromyotoxicity is a less common but serious adverse effect of HCQ.

Observation:

  • This report details a case of HCQ-induced neuromyotoxicity.
  • A literature review identified 10 cases of HCQ neuromyotoxicity from 1965 to 1998.
  • Muscle biopsies consistently showed specific changes: curvilinear bodies, muscle fiber atrophy, and vacuolar degeneration.

Findings:

  • HCQ neuromyotoxicity typically presents as a slowly developing proximal myopathy.
  • Peripheral neuropathy and cardiac myotoxicity can co-occur with the myopathy.

Related Experiment Videos

  • Symptom resolution after discontinuing HCQ is often slow and may be incomplete.

    • Implications:

    • Caucasian race and renal failure may predispose individuals to HCQ neuromyotoxicity.
    • Prompt evaluation for HCQ neuromyotoxicity is recommended for patients on HCQ with proximal myopathy, cardiomyopathy, or neuropathy.
    • Particular vigilance is advised for patients with co-existing renal dysfunction.