Veinot J P, Mai K T, Zarychanski R
Department of Laboratory Medicine, The University of Ottawa Heart Institute, Ottawa Civic Hospital, University of Ottawa, Ontario, Canada.
J Rheumatol. 1998 Jun;25(6):1221-5.
Chloroquine, an agent used in treatment and prophylaxis of malaria, and also known for its antiinflammatory effects in dermatological, rheumatological, and connective tissue disorders, has been reported to cause toxicity, most commonly in the retina and the cardiovascular system. We describe a 60-year-old woman with longstanding rheumatoid arthritis receiving multidrug treatment, including prolonged administration of chloroquine. She developed complete heart block requiring a permanent pacemaker, congestive heart failure, and progressive myopathy. During hospital investigations for her myopathy, she died of acute pulmonary thromboembolism. Although hypertension and possibly amyloidosis were thought to be the cause of her cardiac disease, cardiac and skeletal muscle changes characteristic of chloroquine toxicity were observed. Chloroquine may be an important unsuspected contributing cause of cardiac dysfunction in patients with rheumatological disease. Endomyocardial biopsy should be considered early in the course of diagnosis and management.
氯喹是一种用于治疗和预防疟疾的药物，同时也因其在皮肤病学、风湿病学和结缔组织疾病中的抗炎作用而闻名。据报道，氯喹会导致毒性，最常见的是对视网膜和心血管系统产生毒性。我们描述了一名60岁患有长期类风湿性关节炎的女性，她正在接受包括长期使用氯喹在内的多种药物治疗。她出现了完全性心脏传导阻滞，需要植入永久性起搏器，还出现了充血性心力衰竭和进行性肌病。在住院检查她的肌病期间，她死于急性肺血栓栓塞。尽管高血压以及可能的淀粉样变性被认为是她心脏病的病因，但观察到了氯喹毒性所特有的心脏和骨骼肌变化。氯喹可能是风湿病患者心脏功能障碍的一个重要的未被怀疑的促成因素。在诊断和治疗过程中应尽早考虑进行心内膜活检。
