Challenges in diagnosing hydroxychloroquine myopathy during the COVID-19 pandemic

Roger Pamphlett; Min-Xia Wang; Renee Cf Chan

doi:10.1111/imj.15092

Challenges in diagnosing hydroxychloroquine myopathy during the COVID-19 pandemic

Intern Med J. 2020 Dec;50(12):1559-1562. doi: 10.1111/imj.15092.

Authors

Roger Pamphlett^{1

2}, Min-Xia Wang³, Renee Cf Chan⁴

Affiliations

¹ Department of Neuropathology, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.
² Discipline of Pathology, School of Medical Sciences, Brain and Mind Centre, The University of Sydney, Sydney, New South Wales, Australia.
³ Department of Neurology, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.
⁴ Department of Anatomical Pathology, Electron Microscopy Unit, Concord Repatriation General Hospital, Sydney, New South Wales, Australia.

PMID: 33354884
DOI: 10.1111/imj.15092

Abstract

Hydroxychloroquine is being used for COVID-19 symptoms and in clinical trials, but can cause a toxic myopathy that leads to muscle weakness. A review of skeletal muscle biopsies from patients with hydroxychloroquine myopathy gives pointers of steps that can be taken to diagnose this toxic myopathy early and help differentiate it from COVID-19-related muscle weakness.

Keywords: COVID-19; coronavirus; hydroxychloroquine; muscle weakness; pandemic; toxic myopathy.

MeSH terms

Adult
Aged
Aged, 80 and over
Antirheumatic Agents / administration & dosage
Antirheumatic Agents / adverse effects
COVID-19 / diagnosis*
Diagnosis, Differential
Humans
Hydroxychloroquine / administration & dosage
Hydroxychloroquine / adverse effects*
Middle Aged
Muscle Weakness / chemically induced*
Muscle Weakness / diagnosis*
Muscular Diseases / chemically induced*
Muscular Diseases / diagnosis*
Pandemics

Substances

Antirheumatic Agents
Hydroxychloroquine