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Cardiac toxicity secondary to long term treatment with chloroquine
  1. À CERVERA,
  2. G ESPINOSA,
  3. R CERVERA,
  4. J FONT,
  5. M INGELMO
  1. Systemic Autoimmune Diseases Unit
  2. Department of Medicine
  3. Institut d'Investigacions Biomèdiques Agustí Pi
  4. i Sunyer, Hospital Clínic, School of Medicine
  5. University of Barcelona
  6. Barcelona, Catalonia
  7. Spain
  1. cervera{at}medicina.ub.es

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Chloroquine is frequently used to treat systemic autoimmune diseases, such as systemic lupus erythematosus (SLE). With long term treatment, associated toxicity is well known, with retinopathy been the most common complication. Other chronic complications include skin disorders (hyperpigmentation), blood dyscrasias, corneal deposits, encephalopathy, neuropathy, myopathy, and impairment of auditory function.1 Cardiac complications, such as conduction disorders, myocardial hypertrophy, and restrictive cardiomyopathy, have also been reported in long term treatment.2-10Nevertheless, this problem is underappreciated. We describe a patient with SLE who developed a complete heart block and a restrictive cardiomyopathy owing to chronic treatment with chloroquine.

CASE REPORT

A 64 year old woman was diagnosed with SLE and associated Sjögren's syndrome in 1988. She was treated with chloroquine for seven years (total dose 1000 g). In 1996 she presented a syncope, and a complete heart block was disclosed …

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