title: Restrictive Cardiomyopathy Associated With Long-Term Use of Hydroxychloroquine for Systemic Lupus Erythematosus.
abstract: Hydroxychloroquine (HQ) is commonly prescribed for autoimmune diseases such as systemic lupus erythematosus. We report a case of a 75-year-old female presenting with de novo decompensated heart failure and restrictive cardiomyopathy (left ventricular ejection fraction: 40%-45%) after treatment with HQ for more than 11 years. Hydroxychloroquine was discontinued, and follow-up echocardiogram 57 days after discontinuation showed normalization of her left ventricular ejection fraction. A score of 7 on the Naranjo Adverse Drug Reaction Probability Scale indicates that HQ is a probable cause of this patient's cardiomyopathy. An adverse drug effect due to HQ should be considered in treated patients who present with restrictive cardiomyopathy. Discontinuation may allow for partial or complete reversal of the cardiomyopathy.
authors.affiliation: 1 Department of Pharmacy, Vanderbilt University Medical Center, Nashville, TN, USA.
authors.forename: Leah A
authors.initials: LA
authors.lastname: Sabato
authors.affiliation: 2 Division of Cardiovascular Medicine, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA.
authors.forename: Lisa A
authors.initials: LA
authors.lastname: Mendes
authors.affiliation: 3 Department of Pharmacy Practice, Lipscomb University College of Pharmacy, Nashville, TN, USA.
authors.forename: Zachary L
authors.initials: ZL
authors.lastname: Cox
mesh_terms: D000368:Aged; D000962:Antimalarials / Q000008:administration & dosage / Q000009:adverse effects*; D002313:Cardiomyopathy, Restrictive / Q000139:chemically induced* / Q000000981:diagnostic imaging*; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D006886:Hydroxychloroquine / Q000008:administration & dosage / Q000009:adverse effects*; D008180:Lupus Erythematosus, Systemic / Q000188:drug therapy*; D013997:Time Factors
chemical_list: D000962:Antimalarials; D006886:Hydroxychloroquine
keywords: cardiomyopathy; hydroxychloroquine; restrictive cardiomyopathy; systemic lupus erythematosus