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Washington University Experience | MUSCLE | Hydroxychloroquine myopathy | 6A0 Case 6 History
Case 6 History ---- The patient is a 78 year old man with a history of diabetes, chronic renal failure, syncopal episodes with orthostasis, previous (16 years) lumbar spinal surgery with residua (foot drop) and hypercalcemia provoking concern for possible sarcoidosis. The patient has experienced a few years of severe bilateral lower extremity weakness and sensory loss. EMG/NCS shows diffuse severe axonal sensorimotor peripheral neuropathy of unclear etiology and myopathy. He was hospitalized for a continuing increase in serum calcium and creatinine. Calcitriol levels were also increased, providing additional concern for sarcoidosis, although there was no biopsy proof. As a result the patient was treated with IV bisphosphonate and oral prednisone. Renal failure increased requiring dialysis. He was started on Plaquenil 200mg BID, which is a standard dose of hydroxychloroquine for adults with autoimmune conditions such as systemic lupus erythematosus, sarcoidosis or rheumatoid arthritis. ---- This case is also shown in more detail in the Autophagic Myopathy section of the atlas as case number 11.
