Chronic use of hydroxychloroquine for lupus erythematosus was associated with acquired long QT interval syndrome and torsade de pointes in a 67-year-old female, which resolved upon discontinuation.
Case Report (n=1)
Does chronic hydroxychloroquine use cause QT prolongation and ventricular arrhythmias in patients with lupus erythematosus?
Chronic use of hydroxychloroquine may be associated with acquired long QT syndrome and potentially lethal ventricular arrhythmias such as torsades de pointes.
BACKGROUND: Hydroxychloroquine (HCQ) is used for treatment of lupus erythematosus. The cardiac toxicity of HCQ has focused primarily on acute intoxication. We report a case of chronic use of HCQ associated with torsade de pointes. CASE REPORT: A 67-year-old female presented with acquired long QT interval syndrome with a refractory ventricular arrhythmia. She was receiving chronic therapeutic doses of HCQ for the treatment of lupus erythematosus. Torsades de pointes was diagnosed in the Emergency Department (ED). After excluding other causes of long QT syndrome, the HCQ was suspected as the cause of her ventricular tachycardia. After discontinuing the HCQ, the QT interval was shorter and the patient recovered after treatment with lidocaine and isoproterenol. CONCLUSION: The chronic use of HCQ for rheumatic diseases, or as an anti-malarial drug, should be balanced against the risk of developing potentially lethal cardiac arrhythmias.
Chen et al. (2006) conducted a case report in Lupus erythematosus with acquired long QT interval syndrome and refractory ventricular arrhythmia (n=1). Hydroxychloroquine was evaluated on Acquired long QT interval syndrome and torsade de pointes. Chronic use of hydroxychloroquine for lupus erythematosus was associated with acquired long QT interval syndrome and torsade de pointes in a 67-year-old female, which resolved upon discontinuation.