A Case of Rhabdomyolysis in a Patient with Plasmidium vivax Malaria Treated with Hydroxychloroquine / 감염과화학요법

Rhabdomyolysis is a potentially life-threatening syndrome resulting form the breakdown of skeletal muscle fibers with leakage of muscle contents into the circulation. Rhabdomyolysis may complicate many disease states. In some cases, patients with malaria may be complicated with rhabdomyolysis. Also hydroxychloroquine may induce myopathy and rhabdomyolysis. But there is no case report of rhabdomyolysis after use of hydroxychloroquine in a Korean patient with Plasmodium vivax malaria. Recently we experienced a patient who developed rhabdomyolysis 20 days after starting therapy with hydroxychloroquine for the treatment of P. vivax malaria. We report the case with the review of the literature.

A Case of Rhabdomyolysis in a Patient with Plasmidium vivax Malaria Treated with Hydroxychloroquine / 감염과화학요법

Rhabdomyolysis is a potentially life-threatening syndrome resulting form the breakdown of skeletal muscle fibers with leakage of muscle contents into the circulation. Rhabdomyolysis may complicate many disease states. In some cases, patients with malaria may be complicated with rhabdomyolysis. Also hydroxychloroquine may induce myopathy and rhabdomyolysis. But there is no case report of rhabdomyolysis after use of hydroxychloroquine in a Korean patient with Plasmodium vivax malaria. Recently we experienced a patient who developed rhabdomyolysis 20 days after starting therapy with hydroxychloroquine for the treatment of P. vivax malaria. We report the case with the review of the literature.

Clinical Characteristics of Late-onset Rheumatoid Arthritis / 대한류마티스학회지

OBJECTIVE: Late-onset rheumatoid arthritis (LORA) refereed as the subset of rheumatoid arthritis with age of onset over 60 years old, seems to differ from younger onset disease (YORA) by more equal sex distribution, a higher frequency of abrupt disease onset, more large joints involvement, more extraarticular manifestation, erythrocyte sedimentation test (ESR), and less rheumatoid factor (RF) positivity. We need data of LORA in Korea because of lack of data. METHODS: Two hundred and forty-two patients were studied retrospectively. We compared the difference with clinical manifestation, disease activity markers, RF, ANA, and radiologic changes between LORA and YORA. Sums of ESR and C-reactive protein (CRP) during first year after diagnosis were calculated through area under curve. Radiologic joint damages were evaluated using modified Sharp score. RESULTS: The gender ratio (female/male) was 1.54 in LORA and 6.43 in YORA (p<0.001). The duration of the diagnosis was longer in LORA than in YORA (25.2+/-27.0 months, 18.5+/-22.2 months, p=0.048). Tender and swollen joint, and involvement of joints were not different in the groups. ESR, CRP, platelet, and RF were higher with LORA. Sums of ESR and CRP were higher in LORA than in YORA (403.7+/-252.2 mm/hr, 25.6+/-41.1 mg/dL vs 281.4+/-201.3, 12.0+/-15.0). There was no difference of modified Sharp score in both groups. CONCLUSION: The LORA has an equal gender ratio, longer morning stiffness and disease duration, and higher levels of RF, platelet, ESR, CRP, and summation of ESR and CRP, which suggests that LORA may have poorer prognosis than YORA.