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Updated: Aug 18, 2026

Mouse Models for Graft Arteriosclerosis
Published on: May 14, 2013
Hydroxychloroquine causes severe vacuolar myopathy in a patient with chronic graft-versus-host disease
Javier Bolaños-Meade1, Lan Zhou, Ahmet Hoke
1Department of Oncology, The Johns Hopkins Hospital, Baltimore, Maryland 21287, USA.
Abstract:
A 51-year-old man developed progressive debilitating limb and respiratory muscle weakness while undergoing treatment for chronic graft-versus-host disease secondary to allogeneic bone marrow transplant for mantle cell lymphoma. He had a normal serum creatine kinase level and acetylcholine receptor antibodies were negative. Electromyography showed a severe, nonirritable myopathy and a sensory motor axonal polyneuropathy. A muscle biopsy showed a necrotizing, vacuolar myopathy with many fibers containing autophagic and red-rimmed vacuoles, suggestive of an amphiphilic drug myopathy. The patient's strength and function improved significantly after discontinuation of hydroxychloroquine.
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