A 75-year-old woman presented to the hospital with heart failure that progressed for some time but worsened in the past two weeks, and a remote history of seizure disorder and lupus. An endomyocardial biopsy was performed.
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Hydroxychloroquine (Plaquenil) Cardiomyopathy.
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Whenever there is a suspicion of lupus myocarditis, and a patient is taking Plaquenil, it is a good idea to perform EM. On the light microscopy, there was no evidence of inflammation, but there was evidence of myocyte vacuolization and granular material. This material was slightly larger than lipofuscin.
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