[Chloroquine cardiotoxicity in long-term lupus therapy in two patients].
BACKGROUND
The antimalarial compounds chloroquine and hydroxychloroquine are widely used in the treatment of connective tissue diseases and are usually well tolerated. We report two cases of chloroquine cardiotoxicity.


METHODS
Two women (aged 43 and 48 years) were treated for 5 years for lupus. They developed severe conduction disturbances requiring a pacemaker. Plasma chloroquine concentrations were abnormally high in both cases. In one case, a genetic polymorphism modulating the activity of a cytochrome involved in chloroquine metabolism (CYP2C8) was identified.


CONCLUSIONS
Since 1965, 60 cases of occasionally severe cardiotoxicity have been reported following long-term treatment with chloroquine in most cases, but also with hydroxychloroquine. This toxicity must be detected early and close cardiac assessment is required.
Saussine
A
A
Service de dermatologie, hôpital Bichat-Claude-Bernard, AP-HP, université Paris-7 Denis-Diderot, 46, rue Henri-Huchard, 75877 Paris cedex 18, France.
Loriot
M-A
MA
Picard
C
C
Lecerf
V
V
Landry
J
J
Scheer
I
I
Voicu
S
S
Leenhardt
A
A
Ducrocq
G
G
Maubec
E
E
Crickx
B
B
D000328:Adult; D018501:Antirheumatic Agents / Q000008:administration & dosage / Q000009:adverse effects*; D054537:Atrioventricular Block / Q000139:chemically induced* / Q000628:therapy; D002738:Chloroquine / Q000008:administration & dosage / Q000009:adverse effects*; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008178:Lupus Erythematosus, Cutaneous / Q000150:complications / Q000188:drug therapy; D008180:Lupus Erythematosus, Systemic / Q000150:complications / Q000188:drug therapy; D008875:Middle Aged; D010138:Pacemaker, Artificial; D012859:Sjogren's Syndrome / Q000150:complications / Q000188:drug therapy; D018754:Ventricular Dysfunction / Q000139:chemically induced* / Q000628:therapy
D018501:Antirheumatic Agents; D002738:Chloroquine