Hydroxychloroquine Induced Cardiotoxicity: A Case Series

Artur Schneider1, Jonna Sadhana2, Maximiliano Diaz Menindez1

  • 11Department of Internal Medicine, Mayo Clinic, Jacksonville, FL 32224, USA.

Insights

Hydroxychloroquine (HCQ) cardiotoxicity is a rare condition from chronic use, causing cardiomyopathy. Prompt diagnosis and stopping the drug are crucial to prevent disease progression.

Area of Science:

  • Cardiology
  • Toxicology
  • Pharmacology

Background:

  • Hydroxychloroquine (HCQ) is frequently used for autoimmune conditions.
  • Chronic HCQ use can lead to a rare but serious cardiotoxicity.
  • This cardiotoxicity manifests as a drug-induced cardiomyopathy.

Purpose of the Study:

  • To describe the clinical features and diagnostic findings of HCQ-induced cardiotoxicity.
  • To highlight the importance of early recognition and intervention.
  • To present a case series of biopsy-proven HCQ cardiotoxicity.

Main Methods:

  • Descriptive case series of ten patients.
  • Review of patient history, physical examinations, and advanced imaging.
  • Inclusion of endomyocardial biopsy results for definitive diagnosis.

Main Results:

  • All ten patients were diagnosed with biopsy-proven HCQ cardiotoxicity.
  • Cardiotoxicity was associated with chronic HCQ use.
  • The underlying mechanism involves acquired lysosomal storage defects.

Conclusions:

  • Early recognition of HCQ cardiotoxicity is essential.
  • Discontinuation of HCQ is the primary treatment.
  • Endomyocardial biopsy is the gold standard for diagnosis.