Myocarditis with Cardiac Failure: Initial Manifestation of Systemic Lupus ErythematosusCorrespondence Address :
Dr. Suchi Acharya,
Address: A-1/5, Diamond Park, Joka, Opposite ESI Joka Hospital, Kolkata-700104, West Bengal, India.
Cardiac involvement is very rare in Systemic Lupus Erythematosus (SLE). Pericarditis is the leading cardiovascular manifestation in SLE followed by endocarditis, conduction abnormality, coronary artery disease and myocardial dysfunction. Myocardial dysfunction is most often subclinical, but may rarely progress to ventricular dysfunction, cardiogenic shock or severe congestive heart failure. Myocarditis leading to cardiac failure is a very unusual presentation of childhood lupus. We present a four and half-year-old young boy who presented to us with features of congestive heart failure subsequently diagnosed to be secondary to fulminant lupus myocarditis. Despite intensive management, the child ultimately succumbed. His echocardiography revealed dilated left ventricle with an Ejection Fraction (EF) of 18.2%. A positive titre of p-ANCA was also seen in this case. Although, ANCA positivity has been shown as a bad prognostic marker for lupus nephritis, its association with lupus myocarditis is still unknown. Decongestive measures along with immunosuppressant drugs remain the preferred treatment. This case highlights the protean presentation of SLE in the form of lupus myocarditis leading to congestive heart failure that merits an urgent intervention because of the potentially devastating consequences.
Cyclophosphamide, Heart failure, Pericarditis
Suchi Acharya, Priyankar Pal, Prabhas Prasun Giri, Agnisekhar Saha. MYOCARDITIS WITH CARDIAC FAILURE: INITIAL MANIFESTATION OF SYSTEMIC LUPUS ERYTHEMATOSUS. Journal of Clinical and Diagnostic Research [serial online] 2019 January [cited: 2019 Jan 23 ]; 13:SD01-SD02. Available from
Date of Submission: Sep 17, 2018
Date of Peer Review: Oct 30, 2018
Date of Acceptance: Nov 14, 2018
Date of Publishing: Jan 01, 2019
FINANCIAL OR OTHER COMPETING INTERESTS: None.
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