Specific cardiomyopathy in lupus patients: report of three cases.
Clinically important myocarditis is an unusual feature in patients with systemic lupus erythematosus (SLE). We report three consecutive lupus patients over a 1 year period who developed severe left ventricular dysfunction in the absence of coronary artery disease or hypertensive cardiomyopathy. Two of them had clinical and biological flare of the disease whereas the lupus was quiescent in the latter. Two of them had positive IgG anticardiolipin antibodies. High dose steroids were given in two patients; one of them also required cyclophosphamide on account of diffuse proliferative glomerulonephritis. Left ventricular function improved quickly and markedly in these two patients; one of them had recurrence of severe myocarditis at intervals of 6 years and was each time responsive to steroids. Lupus cardiomyopathy, a rare event in the course of SLE, can be related to the disease even in the absence of coronary artery disease or hypertensive cardiomyopathy. It may be improved by steroids and immunosuppressive therapy. Literature concerning this cardiac manifestation in lupus is reviewed.
Gottenberg
Jacques-Eric
JE
Rheumatology department, Hôpital de Bicêtre, (Assistance Publique-Hôpitaux de Paris [AP-HP]), 78 rue du Général Leclerc, 94275 Le Kremlin Bicêtre cedex, France.
Roux
Sophie
S
Assayag
Patrick
P
Clerc
Didier
D
Mariette
Xavier
X
D000293:Adolescent; D000328:Adult; D017153:Antibodies, Anticardiolipin / Q000032:analysis; D004359:Drug Therapy, Combination; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008180:Lupus Erythematosus, Systemic / Q000150:complications / Q000188:drug therapy / Q000473:pathology*; D008297:Male; D011241:Prednisone / Q000627:therapeutic use; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left / Q000209:etiology / Q000276:immunology / Q000473:pathology*
D017153:Antibodies, Anticardiolipin; D005938:Glucocorticoids; D007074:Immunoglobulin G; D007166:Immunosuppressive Agents; D011241:Prednisone