This Article Full Text (PDF) References Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Law, W G Articles by Chng, H H Search for Related Content PubMed PubMed Citation Articles by Law, W G Articles by Chng, H H Pubmed/NCBI databases Compound via MeSH Substance via MeSH Medline Plus Health Information Cardiomyopathy Lupus Hazardous Substances DB CYCLOPHOSPHAMIDE Social Bookmarking                   What's this?

Acute lupus myocarditis: clinical features and outcome of an oriental case series

Department of Rheumatology, Allergy and Immunology, Tan Tock Seng Hospital, Singapore, weng_giap_law{at}ttsh.com.sg

B Y Thong

Department of Rheumatology, Allergy and Immunology, Tan Tock Seng Hospital, Singapore

T Y Lian

Department of Rheumatology, Allergy and Immunology, Tan Tock Seng Hospital, Singapore

K O Kong

Department of Rheumatology, Allergy and Immunology, Tan Tock Seng Hospital, Singapore

H H Chng

Department of Rheumatology, Allergy and Immunology, Tan Tock Seng Hospital, Singapore

Symptomatic myocarditis in systemic lupus erythematosus (SLE) is uncommon. We describe the clinical characteristics, management and outcomes of 11 SLE patients without any atherosclerotic risk factors, who presented with acute lupus myocarditis (ALM). All patients were female, 46% Chinese with mean age of 27 < 10 years at diagnosis of SLE. ALM was one of the initial manifestations of SLE in eight (73%) patients. The median duration from onset ALM to initiation of treatment was two weeks (range: 0.3-8). All had clinical feature of left ventricle dysfunction. The most common electrocardiographic feature was nonspecific ST/T wave changes (91%). Common echocardiographic findings included segmental wall motion abnormalities (81%) and decreased left ventricular ejection fraction (81%). Median SLE disease activity index at presentation was 16 (range: 4-30). All patients received high dose corticosteroids and 64% received intravenous pulse cyclophosphamide. There were two deaths (18%) from infections. The remaining nine survivors had no recurrence of ALM nor suffer any SLE-related damage (median SLICC damage score of 0), up to a median follow-up of four years (range: 2.5-10.1). Repeat echocardiography after six months or later showed normal LVEF in eight patients (89%). Early immunosuppressive therapy in ALM, with high dose corticosteroids and pulse intravenous cyclophosphamide, results in good cardiac outcome.

Key Words: echocardiography • heart failure • systemic lupus erythematosus

Lupus, Vol. 14, No. 10, 827-831 (2005)
DOI: 10.1191/0961203305lu2228oa


CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

				D Jain and M K Halushka Cardiac pathology of systemic lupus erythematosus J. Clin. Pathol., July 1, 2009; 62(7): 584 - 592. [Abstract] [Full Text] [PDF]

				S-W Lee, M-C Park, Y-B Park, and S-K Lee E/E' ratio is more sensitive than E/A ratio for detection of left ventricular diastolic dysfunction in systemic lupus erythematosus Lupus, March 1, 2008; 17(3): 195 - 201. [Abstract] [PDF]

				M. Apte, G. McGwin Jr, L. M. Vila, R. A. Kaslow, G. S. Alarcon, J. D. Reveille, and for the LUMINA Study Group Associated factors and impact of myocarditis in patients with SLE from LUMINA, a multiethnic US cohort Rheumatology, March 1, 2008; 47(3): 362 - 367. [Abstract] [Full Text] [PDF]

				M. J. Roman and J. E. Salmon Cardiovascular Manifestations of Rheumatologic Diseases Circulation, November 13, 2007; 116(20): 2346 - 2355. [Full Text] [PDF]

				J. Pieretti, M. J. Roman, R. B. Devereux, M. D. Lockshin, M. K. Crow, S. A. Paget, J. E. Schwartz, L. Sammaritano, D. M. Levine, and J. E. Salmon Systemic Lupus Erythematosus Predicts Increased Left Ventricular Mass Circulation, July 24, 2007; 116(4): 419 - 426. [Abstract] [Full Text] [PDF]

				M Al-mashaleh, H Bak, J Moore, N Manolios, and H Englert Resolution of sclerodermatous myocarditis after autologous stem cell transplantation Ann Rheum Dis, September 1, 2006; 65(9): 1247 - 1248. [Full Text] [PDF]