Massive Nonfatal Hydroxychloroquine Ingestion in a Pediatric Patient

Srihari, Priya; Minns, Alicia B.; Gao, Han; Kreshak, Allyson A.

doi:10.1016/j.jemermed.2021.10.043

Cited by 2 publications

(1 citation statement)

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“…In MDCK cells treated with chloroquine, potassium ions were also greatly affected to an even greater level of -48%. A recent medical case of a child that accidentally ingested 10 g of hydroxychloroquine resulted in hypokalemia, 43 a well-documented effect for high dosages of chloroquine. 44 The proposed mechanism for chloroquine's action in causing hypokalemia is its direct binding and inhibition of potassium channels 45 -47 or by Na + K + -ATPase inhibition.…”

Section: Chloroquine Treatment Disrupts Intracellular Storage Of Zinc...mentioning

confidence: 99%

Chloroquine disrupts zinc storage granules in primary Malpighian tubule cells of Drosophila melanogaster

et al. 2022

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Contrasting reports exist in the literature regarding the effect of chloroquine treatment on cellular zinc uptake or secretion. Here we tested the effect of chloroquine administration in the Drosophila model organism. We show that larvae grown on a diet supplemented with 2.5 mg / mL chloroquine lose up to 50% of their stored zinc and around 10% of their total potassium content. This defect in chloroquine-treated animals correlates with the appearance of abnormal autophagolysosomes in the principal cells of the Malpighian tubules, where zinc storage granules reside. We further show that the reported increase of Fluozin-3 fluorescence following treatment of cells with 300 µM chloroquine for one hour may not reflect increased zinc accumulation, since a similar treatment in Madin-Darby canine kidney cells results in a 36% decrease in their total zinc content. Thus, chloroquine should not be considered a zinc ionophore. Zinc supplementation plus chloroquine treatment restored zinc content both in vivo and in vitro, without correcting autophagic or other ionic alterations, notably in potassium, associated with the chloroquine treatment. We suggest that chloroquine or hydroxychloroquine administration to patients could reduce intracellular zinc storage pools and be part of the drug's mechanism in of action.

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Section: Chloroquine Treatment Disrupts Intracellular Storage Of Zinc...mentioning

confidence: 99%