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Histological and ultrastructural findings in chloroquine-induced cardiomyopathy

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Abstract

Light microscopic and ultrastructural findings in patients suffering from chloroquine-induced cardiomyopathy are reviewed. Based on our own observations in an autopsy case, functional and morphological similarities between chloroquine effects and hereditary lysosomal storage diseases are discussed.

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Abbreviations

Cq :

Chloroquine

CMP :

Cardiomyopathy

References

  1. Abu-Aisha H, Abu Sabba HMA (1979) Cardiac arrest after intravenous chloroquine injection. J Trop Med Hyg 82:36–37

    Google Scholar 

  2. August C, Holzhausen HJ, Schmidt H, Stiller D, Seidlitz G, Zschiesche M (1990) Diagnostik lysosomaler Speicherkrankheiten. Zentralbl Allg Pathol Anat 136:443–453

    Google Scholar 

  3. Augustijns P, Geusens P, Verbeke N (1993) Chloroquine levels in blood during chronic treatment of patients with rheumatoid arthritis. Eur J Clin Pharmacol 44:407–410

    Google Scholar 

  4. Billingham ME (1979) Some recent advances in cardiac pathology. Hum Pathol 10:367–382

    Google Scholar 

  5. Carpenter S, Karpati G (1986) Lysosomal storage in human skeletal muscle. Hum Pathol 17:683–703

    Google Scholar 

  6. Davies MJ (1984) The cardiomyopathies: a review of terminology, pathology and pathogenesis. Histopathology 8:363–393

    Google Scholar 

  7. Dolman CL, Chang E (1972) Visceral lesions in amaurotic familial idiocy with curvilinear bodies. Arch Pathol Lab Med 94:425–430

    Google Scholar 

  8. Edwards WD (1987) Cardiomyopathies. Hum Pathol 18:625–636

    Google Scholar 

  9. Estes ML, Ewing-Wilson D, Chou SM, Mitsumoto H, Hanson M, Shirey E, Ratliff NB (1987) Chloroquine neuromyotoxicity. Am J Med 82:447–455

    Google Scholar 

  10. Fabre J, de Freudenreich J, Duckert A (1966) Influence of renal insufficiency on the excretion of chloroquine, phenobarbital, phenothiazines and methacycline. Helv Med Acta 33:307–316

    Google Scholar 

  11. Fox RI (1993) Mechanism of action of hydroxychloroquine as an antirheumatic drug. Semin Arthritis Rheum 23 [Suppl 1]:82–91

    Google Scholar 

  12. Fox RI, Kang HI (1993) Mechanism of action of antimalarial drugs. Lupus 2 [Suppl 1]:9–12

    Google Scholar 

  13. Gonzales-Noriega A, Grubb JH, Talkad V, Sly WS (1980) Chloroquine inhibits lysosomal enzyme pinocytosis and enhances lysosomal enzyme secretion by impairing receptor recycling. Cell Biol 85:839–852

    Google Scholar 

  14. Hughes JT, Esiri M, Oxbury JM, Whitty CWM (1971) Chloroquine myopathy. Q J Med 157:85–93

    Google Scholar 

  15. Iglesias CG, Rodriguez RJJ, Rojo OJM (1993) Restrictive cardiomyopathy caused by chloroquine. Br Heart J 69:451–452

    Google Scholar 

  16. Jackson MJ, Jones DA, Harris EJ (1984) Inhibition of lipid peroxidation in muscle homogenates by phospholipase A-2-inhibitors. Biosci Rep 4:581–587

    Google Scholar 

  17. Kaeser HE (1982) Medikamentös ausgelöstes myasthenisches Syndrom. In: Seitz D, Vogel P (eds) Verhandlungen der Deutschen Gesellschaft für Neurologie, vol II. Springer, Berlin Heidelberg New York, pp 269–276

    Google Scholar 

  18. Klug E (1971) Ultraschallextraktion biologischer Proben. Beitr Gerichtl Med 28:333–339

    Google Scholar 

  19. Kunze K (1982) Medikamentös bedingte Affektionen der Muskulatur. In: Seitz D, Vogel P (eds.) Verhandlungen der Deutschen Gesellschaft für Neurologie, vol II. Springer, Berlin Heidelberg New York, pp 254–267

    Google Scholar 

  20. Kunze K, Kauerz U, Schmoldt A (1987) Drug induced myopathy by hydroxychloroquine. Vet Hum Toxicol 29 [Suppl 2]:59–60

    Google Scholar 

  21. Lansimies E, Laaksonen AL, Juva K (1971) Acute cardiotoxicity of chloroquine and hydroxychloroquine in dogs. Ann Med Exp Bio Fenn 49:45–48

    Google Scholar 

  22. Lie SO, Schofield B (1973) Inactivation of lysosomal function in normal cultured human fibroblasts by chloroquine. Biochem Pharmacol 22:3109–3114

    Google Scholar 

  23. Mackenzie AH (1983) Pharmacologie actions of 4-aminoquinoline compounds. Am J Med 75 [Suppl 1A]:5–10

    Google Scholar 

  24. Mackenzie AH (1983) Dose refinements in long-term therapy of rheumatoid arthritis with antimalarials. Am J Med 75 [Suppl 1A]:40–45

    Google Scholar 

  25. Mastaglia FL, Papadimitriou JM, Dawkins RL, Beveridge B (1977) Vacuolar myopathy associated with chloroquine, lupus erythematosus and thymoma. J Neurol Sci 34:315–328

    Google Scholar 

  26. McAllister HA, Ferrans VJ, Hall RJ, Strickman NE, Bossart MI (1987) Chloroquine-induced cardiomyopathy. Arch Pathol Lab Med 111:953–956

    Google Scholar 

  27. McCann WP, Permisohn R, Palmisano PA (1975) Fatal chloroquine poisoning in a child. Pediatrics 55:536–538

    Google Scholar 

  28. McChesney EW (1983) Animal toxicity and pharmacokinetics of hydroxychloroquine sulfate. Am J Med 75 [Suppl 1A]:11–18

    Google Scholar 

  29. Miller DR, Khalil SK, Nygard GA (1991) Steady state pharmacokinetics of hydroxochloroquine in rheumatoid arthritis patients. DICP 25:1302–1305

    Google Scholar 

  30. Neville HE, Maunder-Sewry CA, McDougall J, Sewell JR, Dubowitz V (1979) Chloroquine-induced cytosomes with curvilinear profiles in muscle. Muscle Nerve 2:376–381

    Google Scholar 

  31. Nilsson O, Fredmann P, Klinghardt GW (1981) Chloroquineinduced accumulation of gangliosides and phospholipides in skeletal muscle. Eur J Biochem 116:565–571

    Google Scholar 

  32. Oli JM, Ihenacho HNC, Talwar RS (1980) Chronic chloroquine toxicity and heart block. East Afr Med J 57:505–507

    Google Scholar 

  33. Ratliff NB, Estes ML, Myles JL, Shirey EK, McMahon JT (1987) Diagnosis of chloroquine cardiomyopathy by endomyocardial biopsy. N Engl J Med 316:191–193

    Google Scholar 

  34. Ridout RM, Decker RS, Wildenthal K (1978) Chloroquine induced lysosomal abnormalities in cultured foetal mouse hearts. J Mol Cell Cardiol 10:175–183

    Google Scholar 

  35. Salmeron G, Lipsky PE (1983) Immunosuppressive potential of antimalarials. Am J Med 75 [Suppl 1A]:19–24

    Google Scholar 

  36. Seitz M (1991) Aktueller Stand der medikamentösen Therapie der chronischen Polyarthritis. Ther Umsch 48:613–623

    Google Scholar 

  37. Tett S (1993) Clinical pharmacokinetics of slow-acting antirheumatic drugs. Clin Pharmacokinet 25:392–407

    Google Scholar 

  38. Tett S, Cutler D, Day R (1990) Antimalarials in rheumatic diseases. Baillieres Clin Rheumatol 4:467–489

    Google Scholar 

  39. Verny C, Gennes C de, Sébastien P, Lê Thi Huong Du, Chapelon C, Piette JC, Chomette G, Godeau P (1992) Troubles de la conduction cardiaque au cours d'un traitment prolonge par chloroquine. Presse Med 21:800–804

    Google Scholar 

  40. Weiner A, Sandberg MA, Gaudio AR, Kini MM, Berson EL (1991) Hydroxychloroquine retinopathy. Am J Ophthalmol 112:528–534

    Google Scholar 

  41. Wray R, Iveson M (1975) Complete heart block and systemic lupus erythematosus. Br Heart J 37:982–983

    Google Scholar 

  42. Zic JA, Horowitz DH, Arzubiaga C, King LE (1991) Treatment of cutaneous sarcoidosis with chloroquine. Arch Dermatol 127:1034–1040

    Google Scholar 

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August, C., Holzhausen, H.J., Schmoldt, A. et al. Histological and ultrastructural findings in chloroquine-induced cardiomyopathy. J Mol Med 73, 73–77 (1995). https://doi.org/10.1007/BF00270580

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