Antimalarial myopathy in a systemic lupus erythematosus patient with quadriparesis and seizures: a case-based review
| Autor: | Sarah L. Patterson, R. Krishna Chaganti, Kashif Jafri, Katherine D Wysham, Amber Nolan, Matthew D. Bucknor, Hengameh Zahed |
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| Rok vydání: | 2017 |
| Předmět: |
Adult
medicine.medical_specialty Weakness Pediatrics Encephalopathy Quadriplegia Quadriceps Muscle Inflammatory myopathy 03 medical and health sciences Antimalarials 0302 clinical medicine Rheumatology Muscular Diseases immune system diseases Prednisone Seizures medicine Humans Lupus Erythematosus Systemic skin and connective tissue diseases Myopathy 030203 arthritis & rheumatology Systemic lupus erythematosus business.industry Hydroxychloroquine General Medicine medicine.disease Surgery Macrophage activation syndrome Female medicine.symptom business 030217 neurology & neurosurgery medicine.drug |
| Zdroj: | Clinical rheumatology. 36(6) |
| ISSN: | 1434-9949 |
| Popis: | Weakness, seizures, and encephalopathy have a broad differential diagnosis in patients with systemic lupus erythematosus (SLE). We present a case of a 26-year-old female with a recent diagnosis of SLE who experienced a clinical deterioration with quadriparesis, seizures, and encephalopathy. Her quadriparesis was found to be secondary to biopsy-proven hydroxychloroquine-induced myopathy with concomitant inflammatory myopathy. Her seizures and encephalopathy were suspected to be multifactorial in the setting of sepsis and critical illness with possible contributions from neuropsychiatric manifestations of SLE and macrophage activation syndrome. She experienced a dramatic clinical recovery with discontinuation of hydroxychloroquine, treatment of lupus disease activity with mycophenolate mofetil and prednisone, and antibiotic treatment for methicillin-sensitive Staphylococcus aureus (MSSA) bacteremia. This case-based review provides a systematic approach to quadriparesis, seizures, and encephalopathy in patients with SLE and an evidence-based discussion of antimalarial myopathy, which is of critical importance given the widespread use of antimalarial medications for rheumatologic diseases. |
| Databáze: | OpenAIRE |
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