Rituximab reversed cardiac involvement of Wegener's granulomatosis: magnetic resonance imaging assessment.
BACKGROUND
Cardiac involvement is a rare manifestation of Wegener granulomatosis (WG). Because its prognosis can be poor, it must be diagnosed early to be treated adequately. We report the disease course of a patient who received rituximab to treat cardiac involvement documented by contrast-enhanced cardiac magnetic resonance imaging (ceCMR).


METHODS
This WG patient developed myocarditis with atrioventricular block. CeCMR proved useful in the diagnosis and follow-up of cardiac involvement. Several unsuccessful regimens preceded the prescription of rituximab. Two months later, regression of the myocarditis shown by ceCMR images was correlated with electrophysiological improvement.


CONCLUSIONS
CeCMR assessment of a heart conduction defect in a patient with WG showed that this tool was useful for the diagnosis and follow-up of cardiac involvement in this vasculitis. Rituximab was an effective treatment in this patient.
Brihaye
Benoit
B
French Vasculitis Study Group, Department of internal medicine, AP-HP, Hôpital Cochin, Université Paris 5 Descartes, F-75679 Paris Cedex 14, France. brihayeb@yahoo.fr
Aouba
Achille
A
Pagnoux
Christian
C
Vignaux
Olivier
O
Le Hello
Claire
C
Guillevin
Loïc
L
D000328:Adult; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D058846:Antibodies, Monoclonal, Murine-Derived; D054537:Atrioventricular Block / Q000188:drug therapy* / Q000209:etiology / Q000473:pathology; D014890:Granulomatosis with Polyangiitis / Q000150:complications / Q000188:drug therapy*; D006801:Humans; D007155:Immunologic Factors / Q000627:therapeutic use*; D019028:Magnetic Resonance Imaging, Cine; D008297:Male; D009205:Myocarditis / Q000188:drug therapy* / Q000209:etiology / Q000473:pathology; D000069283:Rituximab
D000911:Antibodies, Monoclonal; D058846:Antibodies, Monoclonal, Murine-Derived; D007155:Immunologic Factors; D000069283:Rituximab