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Durrance RJ, Movahedian M, Haile W, et al. Systemic Lupus Erythematosus Presenting as Myopericarditis with Acute Heart Failure: A Case Report and Literature Review. Case Rep Rheumatol. 2019;2019:6173276doi: 10.1155/2019/6173276.
Durrance, R. J., Movahedian, M., Haile, W., Teller, K., & Pinsker, R. (2019). Systemic Lupus Erythematosus Presenting as Myopericarditis with Acute Heart Failure: A Case Report and Literature Review. Case reports in rheumatology, 20196173276. https://doi.org/10.1155/2019/6173276
Durrance, Richard Jesse, et al. "Systemic Lupus Erythematosus Presenting as Myopericarditis with Acute Heart Failure: A Case Report and Literature Review." Case reports in rheumatology vol. 2019 (2019): 6173276. doi: https://doi.org/10.1155/2019/6173276
Durrance RJ, Movahedian M, Haile W, Teller K, Pinsker R. Systemic Lupus Erythematosus Presenting as Myopericarditis with Acute Heart Failure: A Case Report and Literature Review. Case Rep Rheumatol. 2019 Jul 24;2019:6173276. doi: 10.1155/2019/6173276. eCollection 2019. PMID: 31428503; PMCID: PMC6681595.
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Case Rep Rheumatol. 2019 Jul 24;2019:6173276. doi: 10.1155/2019/6173276. eCollection 2019.

Systemic Lupus Erythematosus Presenting as Myopericarditis with Acute Heart Failure: A Case Report and Literature Review.

Case reports in rheumatology

Richard Jesse Durrance, Malahat Movahedian, Worku Haile, Katerina Teller, Richard Pinsker

Affiliations

  1. Department of Medicine, Jamaica Hospital Medical Center, 8900 Van Wyck Expressway, Jamaica, NY 11418, USA.
  2. Department of Rheumatology, Jamaica Hospital Medical Center, 8900 Van Wyck Expressway, Jamaica, NY 11418, USA.

PMID: 31428503 PMCID: PMC6681595 DOI: 10.1155/2019/6173276

Abstract

Acutely decompensated dilated cardiomyopathy in a middle-aged patient without the typical risk factor profile presents a clinical dilemma. While cardiomyopathy is a known aspect of systemic lupus erythematosus (SLE), initial clinical presentation as decompensated dilated cardiomyopathy (DCM) is exceedingly rare in the literature. We share the case of a 49-year-old African-American female with no past medical history who presented with overt heart failure of 4 weeks evolution. Workup showed acute onset decompensated dilated cardiomyopathy, with a serologic profile compatible with SLE. She responded well to immunosuppressive steroid therapy. Literature review for SLE presenting as dilated cardiomyopathy with acute heart failure revealed a paucity of clinical evidence and consensus. Therefore, a comprehensive review of case reports was undertaken. A total of 10 cases were identified. Patients were 90% female and averaged 31 years of age. Dyspnea was the most common clinical presentation, and dilated cardiomyopathy with severely compromised left ventricular function was universally appreciated. Clinical presentation to diagnosis averaged 2 weeks. Immunosuppressive therapy regimens were universally employed; however, the regimens varied significantly. High-dose steroid therapy was most commonly used, and clinical and functional recovery was reported in 90% of individual case reports. Within the limited evidence and experience of therapeutic approaches, the efficacy of different singular or combined therapy is based solely on anecdotal case reports. Given the near-complete response to a short course of high-dose steroid therapy as much in the clinical recovery as in the resolution of DCM, the limited evidence based on review of these observational case studies and series supports the initial use of high-dose steroid therapy in acute lupus myocarditis.

Conflict of interest statement

The authors have no potential conflicts of interest to declare with respect to the research, authorship, and publication of this article.

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