A case of suspected hydroxychloroquine-induced cardiomyopathy: From therapy to toxicity

Background

Hydroxychloroquine (HCQ) is a cornerstone treatment for rheumatologic diseases. While it is generally well tolerated, chronic use has rarely been associated with cardiotoxicity. It is believed to occur due to the accumulation of HCQ in lysosomes, which impairs enzyme activity and eventually leads to myocardial fibrosis. Risk factors for HCQ-induced cardiotoxicity include older age, female sex, renal impairment, and prolonged or high cumulative exposure to HCQ.