Giant cell myocarditis: a rare cardiovascular manifestation in a patient with systemic lupus erythematosus
Identifieur interne : 001E70 ( Main/Exploration ); précédent : 001E69; suivant : 001E71Giant cell myocarditis: a rare cardiovascular manifestation in a patient with systemic lupus erythematosus
Auteurs : L. Chung [États-Unis] ; G J Berry [États-Unis] ; E F Chakravarty [États-Unis]Source :
- Lupus [ 0961-2033 ] ; 2005-02.
English descriptors
- Teeft :
- Autoimmune, Autoimmune diseases, Biopsy, Bowel disease, Cardiac, Cardiac transplantation, Chest pain, Clinical diagnosis, Cyclophosphamide, Echocardiogram, Endomyocardial, Endomyocardial biopsy, Erythematosus, Fatal giant cell myocarditis, Giant cell myocarditis, Hemodynamic, Hemodynamic status, Hemodynamic support, Hydroxychloroquine, Idiopathic giant cell myocarditis, Immunosuppression, Immunosuppressive, Immunosuppressive therapy, Initial presentation, Intravenous, Intravenous immunoglobulin, Laboratory studies, Long history, Lupus, Lupus myocarditis, Lupus patient, Lupus patients, Lymphocytic myocarditis, Median survival, Mycophenolate mofetil, Myocarditis, Palo alto, Pericardial effusion, Prominent giant cells, Rare form, Sampling error, Stanford university school, Systemic lupus erythematosus, Transplantation, Troponin levels, Ventricular.
Abstract
Giant cell myocarditis (GCM) is a rare form of myocarditis with a median survival of less than one year. It has been reported to occur in patients with various underlying autoimmune diseases; however, no cases of GCM have been described in patients with clear evidence of underlying systemic lupus erythematosus (SLE). The presentation of GCM may mimic that of lupus myocarditis, including an initial response to immunosuppression. Despite initial clinical similarities, lupus myocarditis and GCM are histologically distinct entities with dramatic differences in prognosis. We report herein a patient with a longstanding history of SLE, who presented acutely with myocarditis, responded well to initial immunosuppression and then subsequently died of progressive heart failure that was found to be due to GCM. Endomyocardial biopsy can help define diagnosis and prognosis of lupus patients presenting with myocarditis, and early referral for cardiac transplantation should be considered in patients diagnosed with GCM.
Url:
DOI: 10.1191/0961203305lu2040cr
Affiliations:
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Chung</name><affiliation wicri:level="2"><country xml:lang="fr">États-Unis</country><wicri:regionArea>Division of Immunology and Rheumatology, Department of Medicine, Stanford University School of Medicine, Palo Alto, CA</wicri:regionArea><placeName><region type="state">Californie</region></placeName></affiliation></author><author wicri:is="90%"><name sortKey="Berry, G J" sort="Berry, G J" uniqKey="Berry G" first="G J" last="Berry">G J Berry</name><affiliation wicri:level="2"><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Pathology, Stanford University School of Medicine, Palo Alto, CA</wicri:regionArea><placeName><region type="state">Californie</region></placeName></affiliation></author><author wicri:is="90%"><name sortKey="Chakravarty, E F" sort="Chakravarty, E F" uniqKey="Chakravarty E" first="E F" last="Chakravarty">E F Chakravarty</name><affiliation></affiliation><affiliation wicri:level="1"><country wicri:rule="url">États-Unis</country></affiliation></author></analytic><monogr></monogr><series><title level="j">Lupus</title><idno type="ISSN">0961-2033</idno><idno type="eISSN">1477-0962</idno><imprint><publisher>Sage Publications</publisher><pubPlace>Sage CA: Thousand Oaks, CA</pubPlace><date type="published" when="2005-02">2005-02</date><biblScope unit="volume">14</biblScope><biblScope unit="issue">2</biblScope><biblScope unit="page" from="166">166</biblScope><biblScope unit="page" to="169">169</biblScope></imprint><idno type="ISSN">0961-2033</idno></series></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0961-2033</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="Teeft" xml:lang="en"><term>Autoimmune</term><term>Autoimmune diseases</term><term>Biopsy</term><term>Bowel disease</term><term>Cardiac</term><term>Cardiac transplantation</term><term>Chest pain</term><term>Clinical diagnosis</term><term>Cyclophosphamide</term><term>Echocardiogram</term><term>Endomyocardial</term><term>Endomyocardial biopsy</term><term>Erythematosus</term><term>Fatal giant cell myocarditis</term><term>Giant cell myocarditis</term><term>Hemodynamic</term><term>Hemodynamic status</term><term>Hemodynamic support</term><term>Hydroxychloroquine</term><term>Idiopathic giant cell myocarditis</term><term>Immunosuppression</term><term>Immunosuppressive</term><term>Immunosuppressive therapy</term><term>Initial presentation</term><term>Intravenous</term><term>Intravenous immunoglobulin</term><term>Laboratory studies</term><term>Long history</term><term>Lupus</term><term>Lupus myocarditis</term><term>Lupus patient</term><term>Lupus patients</term><term>Lymphocytic myocarditis</term><term>Median survival</term><term>Mycophenolate mofetil</term><term>Myocarditis</term><term>Palo alto</term><term>Pericardial effusion</term><term>Prominent giant cells</term><term>Rare form</term><term>Sampling error</term><term>Stanford university school</term><term>Systemic lupus erythematosus</term><term>Transplantation</term><term>Troponin levels</term><term>Ventricular</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Giant cell myocarditis (GCM) is a rare form of myocarditis with a median survival of less than one year. It has been reported to occur in patients with various underlying autoimmune diseases; however, no cases of GCM have been described in patients with clear evidence of underlying systemic lupus erythematosus (SLE). The presentation of GCM may mimic that of lupus myocarditis, including an initial response to immunosuppression. Despite initial clinical similarities, lupus myocarditis and GCM are histologically distinct entities with dramatic differences in prognosis. We report herein a patient with a longstanding history of SLE, who presented acutely with myocarditis, responded well to initial immunosuppression and then subsequently died of progressive heart failure that was found to be due to GCM. Endomyocardial biopsy can help define diagnosis and prognosis of lupus patients presenting with myocarditis, and early referral for cardiac transplantation should be considered in patients diagnosed with GCM.</div></front></TEI><affiliations><list><country><li>États-Unis</li></country><region><li>Californie</li></region></list><tree><country name="États-Unis"><region name="Californie"><name sortKey="Chung, L" sort="Chung, L" uniqKey="Chung L" first="L" last="Chung">L. Chung</name></region><name sortKey="Berry, G J" sort="Berry, G J" uniqKey="Berry G" first="G J" last="Berry">G J Berry</name><name sortKey="Chakravarty, E F" sort="Chakravarty, E F" uniqKey="Chakravarty E" first="E F" last="Chakravarty">E F Chakravarty</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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