CASE STUDIES - Plaquenil neuromyotoxicity

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J Rheumatol. 2000 Dec;27(12):2927-31.

Hydroxychloroquine neuromyotoxicity.

Stein M, Bell MJ, Ang LC.

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

Hydroxychloroquine (HCQ) is commonly prescribed for treatment of

inflammatory arthritis. The most frequently observed serious side effect

is retinal toxicity; however, case reports have described HCQ induced

neuromyotoxicity. We describe a case of HCQ neuromyotoxicity and a

literature review from 1965 to September 1998 using Medline and Embase.

Including our patient, there are 10 reported cases of HCQ

neuromyotoxicity. Muscle biopsy consistently reveals curvilinear bodies

and muscle fiber atrophy with vacuolar changes. Most cases manifest as

insidious onset proximal myopathy that may be associated with peripheral

neuropathy and cardiac myotoxicity. Resolution of symptoms is slow after

discontinuation of therapy and may be incomplete. Possible predisposing

factors include Caucasian race and concomitant renal failure. Patients

treated with HCQ who develop a proximal myopathy, cardiomyopathy, or

neuropathy, especially in the setting of worsening renal function,

should be evaluated for possible HCQ neuromyotoxicity.

PMID: 11128688

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve & db=PubMed & list_uids=1\

1128688 & dopt=Abstract

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