title: [Fiessinger-Leroy-Reiter syndrome with non-obstructive cardiomyopathy treated with methotrexate].
abstract: The case of a 50 year old male with the Fiessinger-Leroy-Reiter syndrome, ankylosing spondylitis and generalised pustular psoriasis is reported. This condition wax complicated by non-obstructive cardiomyopathy, congestive cardiac failure and first-degree atrioventricular block, the site of which was localised by electrophysiological studies (nodal block with an infrahisian conduction defect). After failure of several therapeutic regimes, a spectacular improvement was obtained with Methotrexate associated with a diuretic; the signs of heart failure regressed and the cardiomyopathy stablised. A parallel improvement was seen in the skin, cardiac and articular lesions and has been maintained with an 18 months follow-up. Left ventricular performance was studied by echocardiography. The mechanism of the beneficial effect of Methotrexate is unclear; this therapeutic trial is to be extended to include other cases of primary cardiomyopathy without obstruction.
mesh_terms: D016918:Arthritis, Reactive / Q000150:complications / Q000188:drug therapy*; D009202:Cardiomyopathies / Q000150:complications / Q000188:drug therapy*; D004562:Electrocardiography; D006327:Heart Block / Q000150:complications / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008727:Methotrexate / Q000627:therapeutic use*; D008875:Middle Aged; D013167:Spondylitis, Ankylosing / Q000150:complications / Q000188:drug therapy*
chemical_list: D008727:Methotrexate
vernacular_title: Syndrome de Fiessinger-Leroy-Reiter avec cardiomyopathie non obstructive: traitement par le méthotrexate.