Skip Navigation LinksHome > October 2012 - Volume 18 - Issue 7 > Fatal Antimalarial-Induced Cardiomyopathy: Report of 2 Cases
JCR: Journal of Clinical Rheumatology:
doi: 10.1097/RHU.0b013e31826852db
Case Reports

Fatal Antimalarial-Induced Cardiomyopathy: Report of 2 Cases

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

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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.

© 2012 Lippincott Williams & Wilkins, Inc.

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