A 65-year-old Caucasian woman presented with insidious onset of symmetric bilateral lower and upper limb weakness, which progressed slowly over the last 3 years. The pattern of weakness was mainly proximal, with some minimal to mild distal weakness evolving in recent months. She also developed some tingling and numbness in her toes followed by fingertips over the last year. High risk plaquenil icd 10 Can you take plaquenil and viagra together Can i donate blood if i took chloroquine Plaquenil low stool siga Pathology Axonal loss; Distal Recovery Better in mildly affected More common in patients with skin hyperkeratosis Myopathy Arsenic trioxide Arsine gas Hemolysis Long term Carcinogen, Lung, skin, liver, kidney & bladder Pathophysiology Uncouples oxidative phosphorylation Trivalent As +++ more toxic. Dose related myopathy Daily dosages of chloroquine of 500 mg given for 1 year or longer Drug features At extracellular pH drugs are poorly ionized & penetrate membranes Acid pH in lysosome Cationic region interacts with polar materials Long half-lives 3.5 to 12 days Clinical Weakness, Proximal Distal Pathology Mar 01, 2011 New clinical and ultrastructural findings in hydroxychloroquine-induced cardiomyopathy a report of 2. Cardiac pathology of systemic lupus erythematosus. J Clin. This was attributed to pericarditis based on workup at an outside facility. She unintentionally lost 20 pounds since the onset of weakness. Approximately 3 years ago, the patient had an episode of chest pain lasting several days. Hydroxychloroquine myopathy pathology Pearls & Oy-sters Hydroxychloroquine-induced toxic myopathy., Toxic Myopathies Plaquenil glucose Hydroxychloroquine HCQ is commonly prescribed for treatment of inflammatory arthritis. The most frequently observed serious side effect is retinal toxicity; however, case reports have described HCQ induced neuromyotoxicity. Hydroxychloroquine neuromyotoxicity.. Hydroxychloroquine-Induced Cardiomyopathy Circulation.. Muscle Pathology Overview – Therapath Neuropathology. This article is from June 2011 and may contain outdated material. Download PDF. Many systemic medications may cause retinal toxicity. One such commonly used medication for dermatologic and rheumatologic inflammatory conditions is hydroxychloroquine Plaquenil, a chloroquine derivative. Dermatology and Pathology Service, Complexo Hospitalario Universitario de Vigo, Vigo, Spain See all articles by this author. Search Google Scholar for this author. Severe, reversible dysphagia from chloroquine and hydroxychloroquine myopathy. Can J Neurol Sci 2007; 34. Chloroquine and hydroxychloroquine, commonly used for rheumatologic conditions, are rare yet very important causes of toxic myopathy with vacuolar changes on muscle biopsy. Pompe disease, a glycogenosis due to deficiency of lysosomal acid α-glucosidase GAA, may sometimes show similar yet less marked changes on muscle histopathology.