Intravenous lipid emulsion, with or without hemodialysis, remains controversial but appears to be safe. Despite the lack of formal evidence, sodium bicarbonate appears to be useful and safe in case of QRS widening. Caution is advised when substituting potassium. Sedation with diazepam, early ventilation, and continuous epinephrine infusion are considered effective in treating severe intoxication. Activated charcoal is advised if the patient presents early. Since high-quality scientific evidence is lacking, treatment options are based on experience in chloroquine toxicity. On day 6, she was extubated and after 11 days, she was discharged from the hospital without complications. Treatment with continuous norepinephrine, potassium chloride/phosphate, and sodium bicarbonate was initiated. Because of the reoccurrence of these arrhythmias, intravenous lipid emulsion was administered with fast cardiac stabilization. Cardiac monitoring showed ventricular arrhythmias for which high-dose midazolam and propofol were initiated, resulting in a brief normalization of the cardiac rhythm. We present a case of autointoxication with 20 g hydroxychloroquine in a 35-year-old woman. However, clinicians should be aware of the dangers of hydroxychloroquine intoxication, an insufficiently studied condition. In the context of the current COVID-19 pandemic, there has been renewed interest in the drug hydroxychloroquine.
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