Rapid Onset and Resolution of Hydroxychloroquine Cardiomyopathy: A Case Report

Area of Science:

• Rheumatology
• Cardiology
• Toxicology

Background:

• Systemic lupus erythematosus (SLE) is a chronic autoimmune disease managed with immunomodulators like hydroxychloroquine (HCQ).
• Hydroxychloroquine (HCQ) is a key treatment for SLE, but rare toxic effects can occur.

Observation:

• A patient with SLE on HCQ presented with sudden, severe pericardial effusion and reduced left ventricular ejection fraction.
• Endomyocardial biopsy revealed curvilinear bodies, indicative of HCQ toxicity.

Findings:

• The case confirms hydroxychloroquine cardiotoxicity as a potential cause of heart failure in SLE patients.
• Histopathological findings of curvilinear bodies are diagnostic markers for HCQ-induced cardiomyopathy.

Implications:

• Clinicians should consider HCQ cardiotoxicity in SLE patients with new or worsening heart failure symptoms.
• Prompt diagnosis and cessation of HCQ are vital for managing this severe adverse drug reaction.