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Title of Journal: Rheumatol Int

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Abbravation: Rheumatology International

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Springer-Verlag

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DOI

10.1016/0005-2736(94)90176-7

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1437-160X

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Differential diagnosis of high serum creatine kina

Authors: Jutta G Richter Arnd Becker Benedikt Ostendorf Christof Specker G Stoll E NeuenJacob Matthias Schneider
Publish Date: 2003/05/09
Volume: 23, Issue: 6, Pages: 319-323
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Abstract

We report the clinical and bioptic findings for a 57yearold woman with severe chloroquineinduced myopathy Since 1989 she had been suffering from systemic lupus erythematosus SLE with renal involvement and undergone periods of treatment with azathioprine and cyclophosphamide Additional therapy with chloroquine CQ was started because of arthralgia At the same time slightly increased creatine kinase CK levels were noted Myositis was suspected and the patient was treated with steroids The CK increase persisted however and she developed progressive muscular weakness and muscular atrophy Routine controls revealed markedly elevated CK levels of 1700 U/l The neurological and electrophysiological findings were not typical of myositis Thus muscle biopsy of the deltoid muscle was performed in order to exclude polymyositis or toxic myopathy As it revealed chloroquineinduced myopathy medication was stopped Discriminating between primary SLEinduced affection of the musculoskeletal system and druginduced side effects is important for appropriate treatment of SLE patients

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