LC3 and p62 as diagnostic markers of drug-induced autophagic vacuolar cardiomyopathy: A study of 3 cases

Brianne H. Daniels, Rodney D McComb, Bret C. Mobley, Sakir Humayun Gultekin, Han S. Lee, Marta Margeta

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

Autophagic vacuolar cardiomyopathy is an underrecognized, but potentially fatal, complication of treatment with chloroquine (CQ) and its derivative hydroxychloroquine (HCQ), which are used as therapy for malaria and common connective tissue disorders. Currently, the diagnosis of autophagic vacuolar cardiomyopathy is established through an endomyocardial biopsy and requires electron microscopy, which is not widely available and has a significant potential for sampling error. Recently, we have reported that immunohistochemistry for autophagic markers LC3 and p62 can replace electron microscopy in the diagnosis of HCQ-induced and colchicine-induced autophagic vacuolar skeletal myopathies. In the current study, we use 3 cases of CQ-induced or HCQ-induced cardiomyopathy and 1 HCQ-treated control case to show that the same two markers can be used to diagnose autophagic vacuolar cardiomyopathies by light microscopy. CQ-induced or HCQinduced autophagic vacuolar cardiomyopathy is not universally fatal, but successful treatment requires early detection. By lowering the barriers to diagnosis, the application of these immunohistochemical markers will decrease the number of misdiagnosed patients, thus increasing the likelihood of favorable clinical outcomes.

Original languageEnglish (US)
Pages (from-to)1014-1021
Number of pages8
JournalAmerican Journal of Surgical Pathology
Volume37
Issue number7
DOIs
StatePublished - Jul 1 2013

Fingerprint

Hydroxychloroquine
Cardiomyopathies
Chloroquine
Pharmaceutical Preparations
Electron Microscopy
Selection Bias
Colchicine
Diagnostic Errors
Connective Tissue
Malaria
Microscopy
Therapeutics
Immunohistochemistry
Biopsy
Light

Keywords

  • Autophagy
  • Diagnostic marker
  • Immunohistochemistry
  • Vacuolar cardiomyopathy

ASJC Scopus subject areas

  • Anatomy
  • Surgery
  • Pathology and Forensic Medicine

Cite this

LC3 and p62 as diagnostic markers of drug-induced autophagic vacuolar cardiomyopathy : A study of 3 cases. / Daniels, Brianne H.; McComb, Rodney D; Mobley, Bret C.; Gultekin, Sakir Humayun; Lee, Han S.; Margeta, Marta.

In: American Journal of Surgical Pathology, Vol. 37, No. 7, 01.07.2013, p. 1014-1021.

Research output: Contribution to journalArticle

Daniels, Brianne H. ; McComb, Rodney D ; Mobley, Bret C. ; Gultekin, Sakir Humayun ; Lee, Han S. ; Margeta, Marta. / LC3 and p62 as diagnostic markers of drug-induced autophagic vacuolar cardiomyopathy : A study of 3 cases. In: American Journal of Surgical Pathology. 2013 ; Vol. 37, No. 7. pp. 1014-1021.
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