Heart Involvement in a Woman Treated with Hydroxychloroquine for Systemic Lupus Erythematosus Revealing Fabry Disease
Bibliographic record
Abstract
To the Editor: Chloroquine (CQ) and hydroxychloroquine (HCQ) are widely used in the longterm treatment of connective tissue disease (CTD) and are usually considered safe1. However, these therapies may cause serious adverse events2, including cardiac toxicity3. The cardiomyopathy induced by an antimalarial drug might mimic the cardiac involvement of Fabry disease (FD), a genetic storage disorder that causes a deficiency of a lysosomal enzyme, alpha galactosidase A (GLA). Indeed, CQ and HCQ provoke a dysfunction in the lysosomal enzymes, leading to the impairment of intracellular degradation processes in conjunction with the accumulation of pathological metabolic products4,5. The cardiac presentation of these 2 diseases is close regarding the clinical symptoms as well as the imaging and pathological findings. We report the case of a patient, treated longterm with HCQ, with cardiac disorders revealing FD. A 61-year-old woman was diagnosed 20 years ago for a CTD with dermatological disorders: alopecia, skin rash, and joint pain. The antinuclear antibodies (ANA) were positive at 1/100. Anti-SSa/Ro and anti-dsDNA antibodies were negative. The … Address correspondence to Dr. Y.M. Pers, 371 Avenue du Doyen Gaston Giraud, 34295 Montpellier, France. E-mail: ympers2000{at}yahoo.fr
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".