title: Cardiac damage from chronic use of chloroquine: a case report and review of the literature.
abstract: Chloroquine has been widely used in rheumatological treatment, but potential severe side effects require careful follow-up. Cardiac damage is not a common consequence, but its clinical relevance has not yet been described. We report the case of a 58-year-old woman with rheumatoid arthritis, in whom chronic chloroquine use resulted in major irreversible cardiac damage. She presented with syncopal episodes due to complete atrioventricular block confirmed by electrophysiological study whose changes were concluded to be irreversible and a permanent pacemaker was indicated. Endomyocardial biopsy was also performed to search for histopathological and ultrastructural cardiac damage. We also reviewed the 22 cases of chloroquine-induced cardiopathy described to date as well as its pathophysiology.
authors.affiliation: Heart Institute, Medical School, University of São Paulo, São Paulo, SP, Brazil.
authors.forename: Ricardo Alkmim
authors.initials: RA
authors.lastname: Teixeira
authors.forename: Martino
authors.initials: M
authors.lastname: Martinelli Filho
authors.forename: Luiz Alberto
authors.initials: LA
authors.lastname: Benvenuti
authors.forename: Roberto
authors.initials: R
authors.lastname: Costa
authors.forename: Anísio A
authors.initials: AA
authors.lastname: Pedrosa
authors.forename: Silvana A D
authors.initials: SA
authors.lastname: Nishióka
mesh_terms: D018501:Antirheumatic Agents / Q000009:adverse effects*; D001172:Arthritis, Rheumatoid / Q000188:drug therapy; D002738:Chloroquine / Q000009:adverse effects*; D005260:Female; D006331:Heart Diseases / Q000139:chemically induced* / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D013997:Time Factors
chemical_list: D018501:Antirheumatic Agents; D002738:Chloroquine