TY - JOUR T1 - Heart Involvement in a Woman Treated with Hydroxychloroquine for Systemic Lupus Erythematosus Revealing Fabry Disease JF - The Journal of Rheumatology JO - J Rheumatol SP - 997 LP - 998 DO - 10.3899/jrheum.151357 VL - 43 IS - 5 AU - CLOTILDE CHATRE AU - NATHALIE FILIPPI AU - FRANÇOIS ROUBILLE AU - YVES-MARIE PERS Y1 - 2016/05/01 UR - http://www.jrheum.org/content/43/5/997.abstract N2 - To the Editor:Chloroquine (CQ) and hydroxychloroquine (HCQ) are widely used in the longterm treatment of connective tissue disease (CTD) and are usually considered safe1. However, these therapies may cause serious adverse events2, including cardiac toxicity3. The cardiomyopathy induced by an antimalarial drug might mimic the cardiac involvement of Fabry disease (FD), a genetic storage disorder that causes a deficiency of a lysosomal enzyme, alpha galactosidase A (GLA). Indeed, CQ and HCQ provoke a dysfunction in the lysosomal enzymes, leading to the impairment of intracellular degradation processes in conjunction with the accumulation of pathological metabolic products4,5. The cardiac presentation of these 2 diseases is close regarding the clinical symptoms as well as the imaging and pathological findings. We report the case of a patient, treated longterm with HCQ, with cardiac disorders revealing FD.A 61-year-old woman was diagnosed 20 years ago for a CTD with dermatological disorders: alopecia, skin rash, and joint pain. The antinuclear antibodies (ANA) were positive at 1/100. Anti-SSa/Ro and anti-dsDNA antibodies were negative. The … Address correspondence to Dr. Y.M. Pers, 371 Avenue du Doyen Gaston Giraud, 34295 Montpellier, France. E-mail: ympers2000{at}yahoo.fr ER -