A unique combination of dilated cardiomyopathy and non- compaction cardiomyopathy in 75- year-old female with lupus erythematosus and hydroxychloroquine use

Systemic lupus erythematosus (SLE) is an autoimmune, chronic, and heterogeneous disease. Antimalarial drugs, such as hydroxychloroquine (HCQ) is still an important immunomodulator medicine for the treatment of SLE. Rarely, HCQ toxicity can occur. We report a case of a patient who was admitted to our hospital with clinical symptoms of heart failure with a background of history of SLE and chronic HCQ use. Dilated cardiomyopathy in parallel with increased left ventricular apical trabeculation consistent with left ventricle non-compaction cardiomyopathy (LVNC) was diagnosed. We aim to pinpoint two rare manifestations presenting in the same patient, simultaneously a) the reversible dilated cardiomyopathy after modification of the dose of HCQ and b) the non-reversible left ventricle non compaction cardiomyopathy most likely associated with her underlying disease. HCQ cardiomyopathy is rare but occasionally correlated with undesirable side effects. It is crucial to consider it in any patient taking for prolonged time the medication, who presents with symptoms of heart failure.