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Differential diagnosis of high serum creatine kinase levels in systemic lupus erythematosus

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Abstract

We report the clinical and bioptic findings for a 57-year-old woman with severe chloroquine-induced 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 1,700 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 chloroquine-induced myopathy, medication was stopped. Discriminating between primary SLE-induced affection of the musculoskeletal system and drug-induced side effects is important for appropriate treatment of SLE patients.

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Author notes

  1. G. Stoll

    Present address: Neurologische Klinik, Bayerische Julius-Maximilians-Universität, Josef-Schneider-Strasse 11, 97080, Würzburg, Germany

Authors and Affiliations

  1. Rheumazentrum Düsseldorf, Heinrich-Heine-Universität, Postfach 10 10 07, 40001, Düsseldorf, Germany

    Jutta G. Richter, Arnd Becker, Benedikt Ostendorf, Christof Specker & Matthias Schneider

  2. Department of Neurology, Heinrich Heine University, Düsseldorf, Germany

    G. Stoll

  3. Department of Neuropathology, Heinrich Heine University, Düsseldorf, Germany

    E. Neuen-Jacob

Authors
  1. Jutta G. Richter
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  2. Arnd Becker
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  4. Christof Specker
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  7. Matthias Schneider
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Correspondence to Jutta G. Richter.

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Richter, J.G., Becker, A., Ostendorf, B. et al. Differential diagnosis of high serum creatine kinase levels in systemic lupus erythematosus. Rheumatol Int 23, 319–323 (2003). https://doi.org/10.1007/s00296-003-0309-0

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  • DOI: https://doi.org/10.1007/s00296-003-0309-0

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