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Lupus myocarditis

S Mavrogeni, L Koutsogeorgopoulou, T Dimitroulas, G Markousis-Mavrogenis, G Kolovou
BACKGROUND: Cardiovascular disease (CVD) has been documented in >50% of systemic lupus erythematosus (SLE) patients, due to a complex interplay between traditional risk factors and SLE-related factors. Various processes, such as coronary artery disease, myocarditis, dilated cardiomyopathy, vasculitis, valvular heart disease, pulmonary hypertension and heart failure, account for CVD complications in SLE. METHODS: Electrocardiogram (ECG), echocardiography (echo), nuclear techniques, cardiac computed tomography (CT), cardiovascular magnetic resonance (CMR) and cardiac catheterization (CCa) can detect CVD in SLE at an early stage...
September 29, 2016: Lupus
Mohammad Reza Zamani, Saeed Aslani, Arash Salmaninejad, Mohammad Reza Javan, Nima Rezaei
Programmed death 1 (PD-1) and its ligands, namely PD-L1 and PD-L2, are one of the key factors responsible for inhibitory T cell signaling, mediating the mechanisms of tolerance and providing immune homeostasis. Mounting evidence demonstrates that impaired PD-1:PD-L function plays an important role in a variety of autoimmune diseases such as Type 1 diabetes (T1D), encephalomyelitis, inflammatory bowel diseases (IBD), Rheumatoid Arthritis (RA), autoimmune hepatitis (AIH), Behcet's disease (BD), myasthenia gravis (MG), autoimmune uveitis (AU), Sjögren's syndrome (SjS), systemic lupus erythematosus (SLE), systemic sclerosis (SSc), myocarditis, and ankylosing spondylitis (AS)...
September 15, 2016: Cellular Immunology
Rocio Hinojar, Lucy Foote, Shirish Sangle, Mike Marber, Manuel Mayr, Gerry Carr-White, David D'Cruz, Eike Nagel, Valentina O Puntmann
BACKGROUND: Lupus myocarditis is likely more common than recognized clinically due to non-specific symptoms and lack of reliable non-invasive diagnostic tests. We investigated the role of native T1 and T2 in recognition of active myocardial inflammatory involvement in patients with systemic lupus erythematous (SLE). METHODS: 76 patients with clinically suspected lupus myocarditis (14 males, age: 44±16years) underwent quantitative tissue characterization with native T1 and T2 mapping...
November 1, 2016: International Journal of Cardiology
Nicholas Marinus Batt, Dean Malik, Miranda Harvie, Hemant Sheth
A 40-year-old woman with antiphospholipid syndrome presented with a 5-day history of right upper quadrant (RUQ) pain, radiating posteriorly, associated with fever and vomiting. She was admitted 1-week prior with an upper respiratory infection and erythema multiforme. Clinical assessment revealed sepsis with RUQ tenderness and positive Murphy's sign. Laboratory results showed raised inflammatory markers, along with renal and liver impairment. CT showed bilateral adrenal infarction and inferior vena cava thrombus...
2016: BMJ Case Reports
W-Y Zheng, W-X Zheng, L Hua
Pathway-based analysis approach has exploded in use during the last several years. It is successful in recognizing additional biological insight of disease and finding groupings of risk genes that represent disease developing processes. Therefore, shared pathways, with pleiotropic effects, are important for understanding similar pathogenesis and indicating the common genetic origin of certain diseases. Here, we present a pathway analysis to reveal the potential disease associations between RA and three potential RA-related autoimmune diseases: psoriasis, diabetes mellitus, type 1 (T1D) and systemic lupus erythematosus (SLE)...
May 2016: Molekuliarnaia Biologiia
N Charhon, C Bernard, J C Richard, N Cordel, G Leboucher, C Broussolle, P Sève
INTRODUCTION: Several case reports have reported the benefit of intravenous immunoglobulin therapy in many autoimmune diseases, including systemic lupus erythematosus. CASE REPORTS: Here, we report on two cases of lupus myocarditis treated with high dose of intravenous immunoglobulin. The first patient was a 42-year-old woman who presented with lupus myocarditis that was resistant to corticosteroids and cyclophosphamide, and who was finally successfully treated with a single dose of 2 g/kg of intravenous immunoglobulin...
June 1, 2016: La Revue de Médecine Interne
R Du Toit, P G Herbst, A van Rensburg, L M du Plessis, H Reuter, A F Doubell
BACKGROUND: African American ethnicity is independently associated with lupus myocarditis compared with other ethnic groups. In the mixed racial population of the Western Cape, South Africa, no data exists on the clinical features/outcome of lupus myocarditis. OBJECTIVES: The objective of this study was to give a comprehensive description of the clinical features and outcome of acute lupus myocarditis in a mixed racial population. METHODS: Clinical records (between 2008 and 2014) of adult systemic lupus erythematosus (SLE) patients at a tertiary referral centre were retrospectively screened for a clinical and echocardiographic diagnosis of lupus myocarditis...
May 25, 2016: Lupus
Dhara Chaudhari, Mohammad Al Madani, Kais Al Balbissi Md, Timir K Paul
Systemic lupus erythematosus (SLE) is an autoimmune disease affecting multiple organ systems. Although myocardial involvement and overt myocarditis is rare, life-threatening myocarditis associated with SLE can happen. We report a case of myocarditis associated with SLE with subsequent improvement of cardiac function after immunosuppressive therapy.
September 2015: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
Dhara Chaudhari Md, Mohammad Al Madani Md, Kais Al Balbissi Md, Timir K Paul Md
Systemic lupus erythematosus (SLE) is an autoimmune disease affecting multiple organ systems. Although myocardial involvement and overt myocarditis is rare, life-threatening myocarditis associated with SLE can happen. We report a case of myocarditis associated with SLE with subsequent improvement of cardiac function after immunosuppressive therapy.
September 2015: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
Sophie I Mavrogeni, George Poulos, Petros P Sfikakis, George D Kitas, Genovefa Kolovou, George Theodorakis
Rhythm disturbances and sudden cardiac death (SCD) are important manifestations of cardiac involvement in systemic inflammatory diseases (SID). The commonest events demanding the implantation of a device include ventricular tachycardia and atrioventricular block, mainly diagnosed in sarcoidosis, systemic lupus erythematosus and scleroderma. In SCD, cardiac magnetic resonance (CMR) identified areas of late gadolinium enhancement (LGE) in 71% and provided an arrhythmic substrate in 76%, while during the follow-up, the extent of LGE identified a subgroup at increased risk for future adverse events...
June 2016: Expert Review of Cardiovascular Therapy
S Mavrogeni, R Smerla, G Grigoriadou, G Servos, L Koutsogeorgopoulou, G Karabela, E Stavropoulos, G Spiliotis, G Kolovou, G Papadopoulos
OBJECTIVES: To evaluate the cardiovascular magnetic resonance (CMR) findings in a paediatric population with systemic lupus erythematosus (SLE) and cardiac symptoms. METHODS: Twenty-five SLE children, aged 10.2 ± 2.6 years, with cardiac symptoms and normal routine non-invasive evaluation were examined by CMR, using a 1.5 T system and compared with sex-matched SLE adults. Left ventricular (LV) volumes, ejection fraction, T2 ratio, early (EGE) and late (LGE) gadolinium enhancement were assessed...
March 2016: Lupus
Li Zhang, Yan-Lin Zhu, Meng-Tao Li, Na Gao, Xin You, Qing-Jun Wu, Jin-Mei Su, Min Shen, Li-Dan Zhao, Jin-Jing Liu, Feng-Chun Zhang, Yan Zhao, Xiao-Feng Zeng
BACKGROUND: Myocarditis is an uncommon but serious manifestation of systemic lupus erythematosus (SLE). This study aimed to investigate clinical characteristics and outcomes of lupus myocarditis (LM) and to determine risk factors of LM in hospitalized Chinese patients with SLE. METHODS: We conducted a retrospective case-control study. A total of 25 patients with LM from 2001 to 2012 were enrolled as the study group, and 100 patients with SLE but without LM were randomly pooled as the control group...
October 5, 2015: Chinese Medical Journal
O N Pamuk, M A Balci, S Donmez, G C Tsokos
BACKGROUND: We estimated the prevalence and incidence, clinical features, treatment, and prognosis of systemic lupus erythematosus (SLE) patients in the Thrace region of Turkey. METHODS: We retrospectively evaluated 331 patients (307 female, 24 male, mean age 38.5 years) diagnosed with SLE between 2003 and 2014. Clinical features, treatments, and response to various treatment modalities were recorded. Our hospital has been the only tertiary referral center for rheumatological diseases for a mixed rural and urban population of 620,477 people (306,036 females, 314,411 males) for more than 16 years...
January 2016: Lupus
Melissa K Webb, Scott R Auerbach, Adel K Younoszai, Sonali S Patel, Bruce F Landeck
BACKGROUND: Predicting later outcome around time of diagnosis of acute dilated cardiomyopathy (DCM) is difficult. We hypothesized that strain and strain rate on initial and follow-up echoes were worse in patients with acute DCM from all causes with poor one-year outcomes. METHODS: This was a retrospective study including all patients with DCM aged 0-18 years with left ventricle dilation, low ejection fraction, or low fractional shortening on initial echo. Longitudinal and circumferential strain and systolic and diastolic strain rate were measured on echo at presentation, 1-3 weeks after presentation, and at 1 year...
November 2015: Echocardiography
Tang-Dong Liao, Pablo Nakagawa, Branislava Janic, Martin D'Ambrosio, Morel E Worou, Edward L Peterson, Nour-Eddine Rhaleb, Xiao-Ping Yang, Oscar A Carretero
Systemic lupus erythematosus is an autoimmune disease characterized by the development of auto antibodies against a variety of self-antigens and deposition of immune complexes that lead to inflammation, fibrosis, and end-organ damage. Up to 60% of lupus patients develop nephritis and renal dysfunction leading to kidney failure. N-acetyl-seryl-aspartyl-lysyl-proline, i.e., Ac-SDKP, is a natural tetrapeptide that in hypertension prevents inflammation and fibrosis in heart, kidney, and vasculature. In experimental autoimmune myocarditis, Ac-SDKP prevents cardiac dysfunction by decreasing innate and adaptive immunity...
May 15, 2015: American Journal of Physiology. Renal Physiology
Simon Greulich, Vanessa M Ferreira, Erica Dall'Armellina, Heiko Mahrholdt
Several exogenous or endogenous factors can lead to inflammatory heart disease. Beside infectious myocarditis, other systemic inflammatory disorders such as sarcoidosis, systemic lupus erythematosus (SLE), systemic sclerosis (SSc), Churg-Strauss syndrome, and rheumatoid arthritis can affect the myocardium. Myocardial inflammation may have a major impact on the outcome of these patients, resulting in sudden cardiac death, severe arrhythmias, or end-stage heart failure. The current gold standard for definite confirmation of inflammatory heart disease is endomyocardial biopsy (EMB), but is invasive and suffers low sensitivity and specificity due to sampling errors...
2015: Current Cardiovascular Imaging Reports
Der-Yuan Chen, Yi-Ming Chen, Bor-Show Tzang, Joung-Liang Lan, Tsai-Ching Hsu
Dilated cardiomyopathies (DCM) are a major cause of mortality in patients with systemic lupus erythematosus (SLE). Immune responses induced by human parvovirus B19 (B19) are considered an important pathogenic mechanism in myocarditis or DCM. However, little is known about Th17-related cytokines in SLE patients with DCM about the linkage with B19 infection. IgM and IgG against B19 viral protein, and serum levels of Th17-related cytokines were determined using ELISA in eight SLE patients with DCM and six patients with valvular heart disease (VHD)...
2014: PloS One
Jeonghyun Ahn, Phillip Ruiz, Glen N Barber
Inflammatory diseases such as Aicardi-Goutières syndrome and severe systemic lupus erythematosus are generally lethal disorders that have been traced to defects in the exonuclease TREX1 (DNase III). Mice lacking TREX1 similarly die at an early age through comparable symptoms, including inflammatory myocarditis, through chronic activation of the stimulator of IFN genes (STING) pathway. In this study, we demonstrate that phagocytes rather than myocytes are predominantly responsible for causing inflammation, an outcome that could be alleviated following adoptive transfer of normal bone marrow into TREX1(-/-) mice...
November 1, 2014: Journal of Immunology: Official Journal of the American Association of Immunologists
N Morel, S Georgin-Lavialle, K Levesque, G Guettrot-Imbert, V Le Guern, J Le Bidois, B Bessières, C Brouzes, D Le Mercier, E Villain, A Maltret, N Costedoat-Chalumeau
Neonatal lupus syndrome is associated with transplacental passage of maternal anti-SSA/Ro and anti-SSB/La antibodies. Children display cutaneous, hematological, liver or cardiac features. Cardiac manifestations include congenital heart block (CHB); endocardial fibroelastosis and dilated cardiomyopathy. The prevalence of CHB in newborns of anti-Ro/SSA positive women with known connective tissue disease is between 1 and 2% and the risk of recurrence is around 19%. Skin and systemic lesions are transient, whereas CHB is definitive and associated with significant morbidity and a mortality of 18%...
March 2015: La Revue de Médecine Interne
Mariko L Ishimori, Megha Agarwal, Roy Beigel, Rita K Ng, Nazanin Firooz, Michael H Weisman, Robert J Siegel
OBJECTIVE: Myocarditis is reported to be a common postmortem finding of systemic lupus erythematosus (SLE). However, most case reports on SLE cardiomyopathy (CM) have not found evidence of myocarditis upon biopsy. Our aim was to characterize the nature, course, and reversibility of left ventricular (LV) dysfunction in patients with SLE. METHODS: The records of 526 SLE patients were reviewed. Patients were included if: (1) at least 4 of 11 American College of Rheumatology criteria for SLE were met, (2) testing for erythrocyte sedimentation rate and hs-CRP were performed during hospitalization, and (3) echocardiogram demonstrated left ventricular ejection function (LVEF) <50%...
May 2014: Echocardiography
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