Chloroquine-induced bilateral anterior shoulder dislocation: a unique aetiology for a rare clinical problem

Martin, Alexander Nicholas; Tsekes, Dimitris; White, William J.; Rossouw, D. J.

doi:10.1136/bcr-2015-214292

Cited by 4 publications

(3 citation statements)

References 16 publications

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“…53 966). Muscular spasms can be caused by an epileptic seizure as seen in our cases, 3,17,22,24,26,30,39,51,106,107,109,113,114 an electrocution, 18,20,78,85 toxins (opiate, alcohol, chloroquine, and insecticide), 15,23,37,104,115 a hypoglycemia, 28,45,54 emotionally charged circumstances (nightmare and fear of death), 14,67,74 or from the vibrations of a digging machine 89 …”

Section: Discussionmentioning

confidence: 83%

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Bilateral anterior shoulder dislocations: A review of two cases and the relevant literature

Diallo

Soulama

Kaboré

et al. 2020

Clinical Case Reports

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Bilateral shoulder dislocations are a rare occurrence. 1-6 The two humeral heads dislocate from the scapular glenoid fossa in the same direction (bilateral symmetric shoulder dislocations or BSSD) or in different directions (bilateral asymmetric shoulder dislocations or BASD). There are three subtypes of BSSD (posterior, 1,2 anterior, 3 and inferior 4). BASD are classified as anteroposterior (one side anterior and the other side posterior) 5 or anteroinferior (one side anterior and the other side inferior). 6 Dislocations are acute or recent when recognized in the 21 days from the trauma. After 21 days, dislocations are called chronic or old. Bilateral symmetric posterior shoulder dislocations are the most common type since Cooper in 1839 1 and Myenter in 1902 2 reported the first cases. The literature found less commonly bilateral symmetric anterior shoulder dislocations (BSASD). 7 We report two cases of BSASD, one acute and one chronic case, both after epileptic seizures. We discuss the epidemiology, etiology, mechanism of injury, treatment, and outcome features through an extensive literature review of 133 BSASD reported cases. 3,7-118 2 | CASE HISTORY 2.1 | Case 1 A 30-year-old male patient complained of bilateral shoulder pain at our ED. The patient woke up at night on the ground, a few minutes after falling from bed, but with no recollection of the fall. He had no prior history of epilepsy nor diabetes. An inaugural epileptic grand mal seizure was suspected. At admission, he presented with bilateral shoulder sulcus signs with an inability to rotate his arm internally (Figure 1). The neurovascular status was normal at both shoulders. Bilateral shoulder AP and Bloom-Obata views revealed bilateral subcoracoid anteromedial glenohumeral dislocation without associated fracture (Figure 2). Closed reduction of both shoulders was performed under general anesthesia. With the patient in the supine position,

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Section: Discussionmentioning

confidence: 83%

“…Acute BSASD are mainly managed by closed reduction (CR) 7,8,13,14,17,22,24,27‐30,32,33,35,42,45,47‐52,54,56,58,60,62,63,65,66,68‐72,74‐77,80‐82,84,86‐88,90‐94,96‐99,101‐104,107‐113,116,118 . The presence of an associated lesion often necessitates operative management.…”

Section: Discussionmentioning

confidence: 99%

Bilateral anterior shoulder dislocations: A review of two cases and the relevant literature

Diallo

Soulama

Kaboré

et al. 2020

Clinical Case Reports

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“…A broad spectrum of neurological and psychiatric events was described in patients treated with CQ for malaria, amoebiasis, arthritis, acute myocardial infarction, erythema nodosum leprosum, or COVID-19 [ 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 , 78 , 79 , 80 , 81 , 82 , 83 , 84 , 85 , 86 , 87 , 88 , 89 , 90 , 91 , 92 , 125 , 193 , 195 ]. Nevertheless, in the case of treatment with HCQ, only one case of psychomotor agitation in a patient with RA and one case of psychosis in a patient with SLE were reported [ 74 , 93 ].…”

Section: Resultsmentioning

confidence: 99%

Safety of Short-Term Treatments with Oral Chloroquine and Hydroxychloroquine in Patients with and without COVID-19: A Systematic Review

et al. 2022

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Chloroquine (CQ) and hydroxychloroquine (HCQ) have recently become the focus of global attention as possible treatments for Coronavirus Disease 2019 (COVID-19). The current systematic review aims to assess their safety in short treatments (≤14 days), whether used alone or in combination with other drugs. Following the PRISMA and SWiM recommendations, a search was conducted using four health databases for all relevant English-, Chinese-, and Spanish-language studies from inception through 30 July 2021. Patients treated for any condition and with any comparator were included. The outcomes of interest were early drug adverse effects and their frequency. A total of 254 articles met the inclusion criteria, including case and case-control reports as well as cross-sectional, cohort, and randomised studies. The results were summarised either qualitatively in table or narrative form or, when possible (99 studies), quantitatively in terms of adverse event frequencies. Quality evaluation was conducted using the CARE, STROBE, and JADAD tools. This systematic review showed that safety depended on drug indication. In COVID-19 patients, cardiac adverse effects, such as corrected QT interval prolongation, were relatively frequent (0–27.3% and up to 33% if combined with azithromycin), though the risk of torsade de pointes was low. Compared to non-COVID-19 patients, COVID-19 patients experienced a higher frequency of cardiac adverse effects regardless of the regimen used. Dermatological adverse effects affected 0–10% of patients with autoimmune diseases and COVID-19. A broad spectrum of neuropsychiatric adverse effects affected patients treated with CQ for malaria with variable frequencies and some cases were reported in COVID-19 patients. Gastrointestinal adverse effects occurred regardless of drug indication affecting 0–50% of patients. In conclusion, CQ and HCQ are two safe drugs widely used in the treatment of malaria and autoimmune diseases. However, recent findings on their cardiac and neuropsychiatric adverse effects should be considered if these drugs were to be proposed as antivirals again.

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Neuropsychiatric Quinism: Chronic Encephalopathy Caused by Poisoning by Mefloquine and Related Quinoline Drugs

Nevin¹

2019

Veteran Psychiatry in the US

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Chloroquine-induced bilateral anterior shoulder dislocation: a unique aetiology for a rare clinical problem

Cited by 4 publications

References 16 publications

Bilateral anterior shoulder dislocations: A review of two cases and the relevant literature

Bilateral anterior shoulder dislocations: A review of two cases and the relevant literature

Safety of Short-Term Treatments with Oral Chloroquine and Hydroxychloroquine in Patients with and without COVID-19: A Systematic Review

Neuropsychiatric Quinism: Chronic Encephalopathy Caused by Poisoning by Mefloquine and Related Quinoline Drugs

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