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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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Autores principales: Ikić Matijašević, Marina, Grubić Rotkvić, Petra, Planinić, Zrinka, Ikić, Lucija, Zadro Kordić, Ines, Galić, Edvard
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10143379/
https://www.ncbi.nlm.nih.gov/pubmed/37103013
http://dx.doi.org/10.3390/jcdd10040134
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author Ikić Matijašević, Marina
Grubić Rotkvić, Petra
Planinić, Zrinka
Ikić, Lucija
Zadro Kordić, Ines
Galić, Edvard
author_facet Ikić Matijašević, Marina
Grubić Rotkvić, Petra
Planinić, Zrinka
Ikić, Lucija
Zadro Kordić, Ines
Galić, Edvard
author_sort Ikić Matijašević, Marina
collection PubMed
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.
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spelling pubmed-101433792023-04-29 Perimyocarditis as First Manifestation of Systemic Lupus Erythematosus Successfully Treated with Heart Failure and Immunosuppressive Therapy Ikić Matijašević, Marina Grubić Rotkvić, Petra Planinić, Zrinka Ikić, Lucija Zadro Kordić, Ines Galić, Edvard J Cardiovasc Dev Dis Case Report 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. MDPI 2023-03-23 /pmc/articles/PMC10143379/ /pubmed/37103013 http://dx.doi.org/10.3390/jcdd10040134 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Case Report
Ikić Matijašević, Marina
Grubić Rotkvić, Petra
Planinić, Zrinka
Ikić, Lucija
Zadro Kordić, Ines
Galić, Edvard
Perimyocarditis as First Manifestation of Systemic Lupus Erythematosus Successfully Treated with Heart Failure and Immunosuppressive Therapy
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 Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10143379/
https://www.ncbi.nlm.nih.gov/pubmed/37103013
http://dx.doi.org/10.3390/jcdd10040134
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