However, the exact mechanism of HCQ cardiotoxicity remains unclear and it is difficult to identify risk factors. We present a case of twin sisters who both suffered from systemic lupus erythematosus (SLE) and HCQ-induced cardiomyopathy presenting with decompensated heart failure (HF), suggesting that genetic predisposition might be a factor in HCQ-induced cardiomyopathy. Plaquenil for gvhd Chloroquine resistance to antimalarail drugs Cardiomyopathy related to antimalarial therapy with illustrative case report. Champion HC, Wigley FM, Halushka MK. New clinical and ultrastructural findings in hydroxychloroquine-induced cardiomyopathy a report of 2 cases. Hum Pathol. 2007; 58–1863. Crossref Medline Google Scholar; 3. Jain D, Halushka MK. Cardiac pathology of. Hydroxychloroquine myopathy is thought to be underestimated with prior reports noting normal CK levels in patients with typical biopsy features of vacuoles and curvilinear bodies. Duration of drug and dose are not well defined in myopathy; onset of symptoms may vary months to years; typical symptoms are nonspecific mild to moderate proximal muscle weakness with slightly elevated to normal CK levels. Curvilinear inclusion bodies were first described by Müller-Höcker et al. as an intermingled twisted microtubular substructure found in vascular smooth muscle cells and podocytes. More recently, Ferluga 7 demonstrated similar curvilinear bodies CLB in renal biopsies in a small case series of chloroquine-induced iatrogenic phospholipidosis. Retinal toxicity, neuromyopathy, and cardiac toxicity are recognized toxicities following prolonged use (1). Hydroxychloroquine (HCQ) is one of the antimalarial drugs that have been used for decades to treat rheumatic diseases (1). Curvilinear bodies hydroxychloroquine cardiomyopathy Hypertrophic cardiomyopathy in a lupus patient a case of., Hydroxychloroquine and Colchicine Induced Myopathy The. Plaquenil screening form Hydroxychloroquine sulfate greater than 6.5 mg/kg 5 mg/kg base of actual body weight, durations of use greater than five years, subnormal glomerular filtration, use of some concomitant drug products such as tamoxifen citrate and concurrent macular disease. PLAQUENIL HYDROXYCHLOROQUINE SULFATE TABLETS, USP DESCRIPTION. Curvilinear bodies in hydroxychloroquine-induced renal.. Final Diagnosis -- Hydroxychloroquine myopathy - UPMC. Oct 30, 2019 Daily hydroxychloroquine base doses 5 mg/kg actual body weight were associated with an ~10% risk of retinal toxicity within 10 years of treatment and an almost 40% risk after 20 years of therapy. Risk is most accurately assessed on the basis of duration of use relative to daily dose/body weight Marmor AAO 2016; Melles 2014. Electron microscopy revealed disorganized myofibrils, abundant vacuoles, multiple lamellar inclusion bodies, and curvilinear cytoplasmic bodies, findings that are pathognomonic for hydroxychloroquine-induced restrictive cardiomyopathy Figure. Hydroxychloroquine was discontinued, and the patient started on guideline directed heart failure therapy. Ultra-structurally, lamellar and so-called “curvilinear” inclusion bodies can be demonstrated. The curvilinear bodies are comma-shaped structures which in human pathology occur only in cases of CQ damage and in neuronal ceroid lipofuscinosis, a group of hereditary neurodegenerative disorders in children 7,8,40.