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Hydroxychloroquine (HCQ) treatment in systemic lupus erythematosus can induce drug‐induced phospholipidosis mimicking Fabry disease. A 32‐year‐old woman with lupus nephritis developed podocyte “zebra bodies” on electron microscopy. Normal lyso‐Gb3 excluded Fabry disease, confirming HCQ toxicity. Discontinuation and immunosuppression yielded stable renal function and improved proteinuria.
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Tsao et al. (2026) studied this question.
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