Abstract
Hydroxychloroquine (HCQ) is widely used in the treatment of systemic lupus erythematosus (SLE) and other autoimmune diseases due to its immunomodulatory and anti-inflammatory properties. Although generally well-tolerated, rare cases of HCQ-induced cardiomyopathy have been reported, often leading to irreversible cardiac dysfunction. We present a case of a 21-year-old female with SLE and biopsy-proven class II lupus nephritis who developed reversible cardiomyopathy associated with HCQ use. Prompt discontinuation of HCQ and initiation of guideline-directed medical therapy (GDMT) resulted in normalization of cardiac function. This case underscores the importance of early recognition and management of HCQ-induced cardiomyopathy, as well as the need for close cardiovascular monitoring in patients on long-term HCQ therapy.