Hydroxychloroquine Cardiotoxicity and Sarcomeric Hypertrophic Cardiomyopathy
Bibliographic record
Abstract
BACKGROUND: Hydroxychloroquine cardiotoxicity is a rare cause of dilated or restrictive cardiomyopathy. CASE SUMMARY: A 50-year-old male with a prior clinical diagnosis of hypertrophic cardiomyopathy presented with monomorphic ventricular tachycardia. Cardiac magnetic resonance imaging (CMR) revealed biventricular hypertrophy and systolic dysfunction, with diffuse nonischemic fibrosis. Endomyocardial biopsy (EMB) revealed myocyte hypertrophy and interstitial fibrosis, consistent with hypertrophic cardiomyopathy, and vacuolated myocytes and myeloid bodies, consistent with hydroxychloroquine cardiotoxicity. Genetic testing found a heterozygous pathogenic MYBPC3 intronic variant, confirming the diagnosis of sarcomeric hypertrophic cardiomyopathy. DISCUSSION: Hydroxychloroquine is an underrecognized cause of cardiotoxicity, particularly in patients with a preexisting cardiomyopathy. In the setting of preexisting cardiomyopathy with clinical deterioration and suspicion of a superimposed process, CMR, EMB, and genetic testing can provide diagnostic clarity and facilitate cascade screening.
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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) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| 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".