Perimyocarditis as First Manifestation of Systemic Lupus Erythematosus Successfully Treated with Heart Failure and Immunosuppressive Therapy
Systemic lupus erythematosus (SLE) myocarditis is presumed to be rare, but associated with adverse outcomes. If SLE diagnosis has not previously been established, its clinical presentation is often unspecific and difficult to recognize. Furthermore, there is a lack of data in the scientific literatu...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-03-01
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| Series: | Journal of Cardiovascular Development and Disease |
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| Online Access: | https://www.mdpi.com/2308-3425/10/4/134 |
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| author | Marina Ikić Matijašević Petra Grubić Rotkvić Zrinka Planinić Lucija Ikić Ines Zadro Kordić Edvard Galić |
| author_facet | Marina Ikić Matijašević Petra Grubić Rotkvić Zrinka Planinić Lucija Ikić Ines Zadro Kordić Edvard Galić |
| author_sort | Marina Ikić Matijašević |
| collection | DOAJ |
| description | Systemic lupus erythematosus (SLE) myocarditis is presumed to be rare, but associated with adverse outcomes. If SLE diagnosis has not previously been established, its clinical presentation is often unspecific and difficult to recognize. Furthermore, there is a lack of data in the scientific literature regarding myocarditis and its treatment in systemic immune-mediated diseases, leading to its late recognition and undertreatment. We present the case of a young woman whose first lupus manifestations included acute perimyocarditis, among other symptoms and signs that provided clues to the diagnosis of SLE. Transthoracic and speckle tracking echocardiography were helpful in detecting early abnormalities in the myocardial wall thickness and contractility while waiting for cardiac magnetic resonance. Since the patient presented with acute decompensated heart failure (HF), HF treatment was promptly started in parallel with immunosuppressive therapy, with a good response. In the treatment of myocarditis with heart failure, we were guided by the clinical signs, echocardiographic findings, biomarkers of myocardial stress, necrosis, and systemic inflammation, as well as markers of SLE disease activity. |
| first_indexed | 2024-03-11T04:54:07Z |
| format | Article |
| id | doaj.art-7b53d0d226574bc2aaf009d4f455d2c1 |
| institution | Directory Open Access Journal |
| issn | 2308-3425 |
| language | English |
| last_indexed | 2024-03-11T04:54:07Z |
| publishDate | 2023-03-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Cardiovascular Development and Disease |
| spelling | doaj.art-7b53d0d226574bc2aaf009d4f455d2c12023-11-17T19:47:17ZengMDPI AGJournal of Cardiovascular Development and Disease2308-34252023-03-0110413410.3390/jcdd10040134Perimyocarditis as First Manifestation of Systemic Lupus Erythematosus Successfully Treated with Heart Failure and Immunosuppressive TherapyMarina Ikić Matijašević0Petra Grubić Rotkvić1Zrinka Planinić2Lucija Ikić3Ines Zadro Kordić4Edvard Galić5Internal Medicine Clinic, University Hospital Sveti Duh, 10 000 Zagreb, CroatiaInternal Medicine Clinic, University Hospital Sveti Duh, 10 000 Zagreb, CroatiaInternal Medicine Clinic, University Hospital Sveti Duh, 10 000 Zagreb, CroatiaDepartment of Anatomy and Physiology, University of Applied Health Sciences, 10 000 Zagreb, CroatiaInternal Medicine Clinic, University Hospital Sveti Duh, 10 000 Zagreb, CroatiaInternal Medicine Clinic, University Hospital Sveti Duh, 10 000 Zagreb, CroatiaSystemic lupus erythematosus (SLE) myocarditis is presumed to be rare, but associated with adverse outcomes. If SLE diagnosis has not previously been established, its clinical presentation is often unspecific and difficult to recognize. Furthermore, there is a lack of data in the scientific literature regarding myocarditis and its treatment in systemic immune-mediated diseases, leading to its late recognition and undertreatment. We present the case of a young woman whose first lupus manifestations included acute perimyocarditis, among other symptoms and signs that provided clues to the diagnosis of SLE. Transthoracic and speckle tracking echocardiography were helpful in detecting early abnormalities in the myocardial wall thickness and contractility while waiting for cardiac magnetic resonance. Since the patient presented with acute decompensated heart failure (HF), HF treatment was promptly started in parallel with immunosuppressive therapy, with a good response. In the treatment of myocarditis with heart failure, we were guided by the clinical signs, echocardiographic findings, biomarkers of myocardial stress, necrosis, and systemic inflammation, as well as markers of SLE disease activity.https://www.mdpi.com/2308-3425/10/4/134systemic lupus erythematosusheart failuremyocarditispericarditisspeckle tracking echocardiographytransthoracic echocardiography |
| spellingShingle | Marina Ikić Matijašević Petra Grubić Rotkvić Zrinka Planinić Lucija Ikić Ines Zadro Kordić Edvard Galić Perimyocarditis as First Manifestation of Systemic Lupus Erythematosus Successfully Treated with Heart Failure and Immunosuppressive Therapy Journal of Cardiovascular Development and Disease systemic lupus erythematosus heart failure myocarditis pericarditis speckle tracking echocardiography transthoracic echocardiography |
| title | Perimyocarditis as First Manifestation of Systemic Lupus Erythematosus Successfully Treated with Heart Failure and Immunosuppressive Therapy |
| title_full | Perimyocarditis as First Manifestation of Systemic Lupus Erythematosus Successfully Treated with Heart Failure and Immunosuppressive Therapy |
| title_fullStr | Perimyocarditis as First Manifestation of Systemic Lupus Erythematosus Successfully Treated with Heart Failure and Immunosuppressive Therapy |
| title_full_unstemmed | Perimyocarditis as First Manifestation of Systemic Lupus Erythematosus Successfully Treated with Heart Failure and Immunosuppressive Therapy |
| title_short | Perimyocarditis as First Manifestation of Systemic Lupus Erythematosus Successfully Treated with Heart Failure and Immunosuppressive Therapy |
| title_sort | perimyocarditis as first manifestation of systemic lupus erythematosus successfully treated with heart failure and immunosuppressive therapy |
| topic | systemic lupus erythematosus heart failure myocarditis pericarditis speckle tracking echocardiography transthoracic echocardiography |
| url | https://www.mdpi.com/2308-3425/10/4/134 |
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