Biomaterial Database

Chronic hydroxychloroquine use associated with QT prolongation and refractory ventricular arrhythmia. 2006

Chun-Yu Chen, and Feng-Lin Wang, and Chih-Chuan Lin

Department of Emergency Medicine, Chang Gung Memorial Hospital, Taipei, Taiwan.

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. METHODS 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. CONCLUSIONS 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.

UI	MeSH Term	Description	Entries
D008133	Long QT Syndrome	A condition that is characterized by episodes of fainting (SYNCOPE) and varying degree of ventricular arrhythmia as indicated by the prolonged QT interval. The inherited forms are caused by mutation of genes encoding cardiac ion channel proteins. The two major forms are ROMANO-WARD SYNDROME and JERVELL-LANGE NIELSEN SYNDROME.	Electrocardiogram QT Prolonged
D008180	Lupus Erythematosus, Systemic	A chronic, relapsing, inflammatory, and often febrile multisystemic disorder of connective tissue, characterized principally by involvement of the skin, joints, kidneys, and serosal membranes. It is of unknown etiology, but is thought to represent a failure of the regulatory mechanisms of the autoimmune system. The disease is marked by a wide range of system dysfunctions, an elevated erythrocyte sedimentation rate, and the formation of LE cells in the blood or bone marrow.	Libman-Sacks Disease,Lupus Erythematosus Disseminatus,Systemic Lupus Erythematosus,Disease, Libman-Sacks,Libman Sacks Disease
D004562	Electrocardiography	Recording of the moment-to-moment electromotive forces of the HEART as projected onto various sites on the body's surface, delineated as a scalar function of time. The recording is monitored by a tracing on slow moving chart paper or by observing it on a cardioscope, which is a CATHODE RAY TUBE DISPLAY.	12-Lead ECG,12-Lead EKG,12-Lead Electrocardiography,Cardiography,ECG,EKG,Electrocardiogram,Electrocardiograph,12 Lead ECG,12 Lead EKG,12 Lead Electrocardiography,12-Lead ECGs,12-Lead EKGs,12-Lead Electrocardiographies,Cardiographies,ECG, 12-Lead,EKG, 12-Lead,Electrocardiograms,Electrocardiographies, 12-Lead,Electrocardiographs,Electrocardiography, 12-Lead
D005260	Female		Females
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D006886	Hydroxychloroquine	A chemotherapeutic agent that acts against erythrocytic forms of malarial parasites. Hydroxychloroquine appears to concentrate in food vacuoles of affected protozoa. It inhibits plasmodial heme polymerase. (From Gilman et al., Goodman and Gilman's The Pharmacological Basis of Therapeutics, 9th ed, p970)	Hydroxychlorochin,Oxychlorochin,Oxychloroquine,Hydroxychloroquine Sulfate,Hydroxychloroquine Sulfate (1:1) Salt,Plaquenil
D000368	Aged	A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available.	Elderly
D013997	Time Factors	Elements of limited time intervals, contributing to particular results or situations.	Time Series,Factor, Time,Time Factor
D018501	Antirheumatic Agents	Drugs that are used to treat RHEUMATOID ARTHRITIS.	Anti-Rheumatic Agent,Anti-Rheumatic Drug,Antirheumatic Agent,Antirheumatic Disease-Modifying Second-Line Drug,Antirheumatic Drug,DMARD,Disease-Modifying Antirheumatic Drug,Disease-Modifying Antirheumatic Drugs,Anti-Rheumatic Agents,Anti-Rheumatic Agents, Non-Steroidal,Anti-Rheumatic Drugs,Antirheumatic Disease-Modifying Second-Line Drugs,Antirheumatic Drugs,Antirheumatic Drugs, Disease-Modifying,Disease-Modifying, Antirheumatic Second-Line Drugs,Agent, Anti-Rheumatic,Agent, Antirheumatic,Anti Rheumatic Agent,Anti Rheumatic Agents,Anti Rheumatic Agents, Non Steroidal,Anti Rheumatic Drug,Anti Rheumatic Drugs,Antirheumatic Disease Modifying Second Line Drug,Antirheumatic Disease Modifying Second Line Drugs,Antirheumatic Drug, Disease-Modifying,Antirheumatic Drugs, Disease Modifying,Disease Modifying Antirheumatic Drug,Disease Modifying Antirheumatic Drugs,Disease Modifying, Antirheumatic Second Line Drugs,Drug, Anti-Rheumatic,Drug, Antirheumatic,Drug, Disease-Modifying Antirheumatic,Non-Steroidal Anti-Rheumatic Agents
D018879	Ventricular Premature Complexes	A type of cardiac arrhythmia with premature contractions of the HEART VENTRICLES. It is characterized by the premature QRS complex on ECG that is of abnormal shape and great duration (generally >129 msec). It is the most common form of all cardiac arrhythmias. Premature ventricular complexes have no clinical significance except in concurrence with heart diseases.	Extrasystole, Ventricular,Premature Ventricular Beats,Premature Ventricular Contractions,Ventricular Ectopic Beats,Premature Ventricular Complex,Ventricular Premature Complex,Ectopic Beat, Ventricular,Ectopic Beats, Ventricular,Premature Ventricular Beat,Premature Ventricular Contraction,Ventricular Beat, Premature,Ventricular Beats, Premature,Ventricular Complex, Premature,Ventricular Contraction, Premature,Ventricular Contractions, Premature,Ventricular Ectopic Beat,Ventricular Extrasystole,Ventricular Extrasystoles