• T Lenfant, J Dion, T Maisonobe, and N Costedoat-Chalumeau.
• Service de médecine interne pôle médecine, centre de référence maladies auto-immunes et systémiques rares, hôpital Cochin, AP-HP, 27, rue du Faubourg Saint-Jacques, 75679 Paris cedex 14, France.
• Rev Med Interne. 2020 May 1; 41 (5): 335-338.

IntroductionThis case report signifies the need to systemically assess antimalarial toxicity in those undergoing long-term treatment.Case ReportA 59-year-old man with a history of ischemic-labeled heart disease revealed by conduction disorders and cutaneous lupus treated initially with hydroxychloroquine followed by chloroquine consulted for asthenia and weight loss. Clinically, he had a muscular atrophy, a motor deficit, and an abolition of the osteo-tendinous reflexes in the lower limbs. Adverse drug effects of the antimalarial therapy were suspected-specifically, muscular and cardiac toxicity. The diagnosis was confirmed with a muscle biopsy, which showed typical and florid vacuolar myopathy. Cessation of the drug resulted in a slow regression of symptoms.ConclusionCardiac and muscular toxicity related to antimalarials are rare and sometimes fatal; thus, they must be systematically assessed in a patient with several years of exposure. A muscle biopsy could be sufficient to allow for the diagnosis.Copyright © 2020 Société Nationale Française de Médecine Interne (SNFMI). Published by Elsevier Masson SAS. All rights reserved.

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