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Lupus myocarditis

Ritambhra Nada, Joseph L Matthews, Sagar Bhattad, Anju Gupta, Surjit Singh
A 10-year-old child presented with prolonged fever, lymphadenopathy, weight loss, oral ulcers, alopecia and parotitis. She later developed arterial thrombosis, poly-serositis, nephritis, myocarditis, sacro-ilitis, autoimmune hemolytic anemia and refractory thrombocytopenia. Though anti-dsDNA was negative, she was diagnosed to have systemic lupus erythematosus (SLE). Terminally, she had pulmonary symptoms and succumbed to her illness. The autopsy showed lupus nephritis-Class II, polyserositis, myocarditis, inflammatory myositis, immune mediated vasculitis involving renal, coronary, pancreatic, adrenal, dermal and intramuscular arteries, and pulmonary hemorrhages and edema...
February 15, 2017: Indian Pediatrics
Muneer G Hasham, Nicoleta Baxan, Daniel J Stuckey, Jane Branca, Bryant Perkins, Oliver Dent, Ted Duffy, Tolani S Hameed, Sarah E Stella, Mohammed Bellahcene, Michael D Schneider, Sian E Harding, Nadia Rosenthal, Susanne Sattler
Systemic autoimmune diseases such as systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA) show significant heart involvement and cardiovascular morbidity, which can be due to systemically increased levels of inflammation or direct autoreactivity targeting cardiac tissue. Despite high clinical relevance, cardiac damage secondary to systemic autoimmunity lacks inducible rodent models. Here, we characterise immune-mediated cardiac tissue damage in a new model of SLE induced by topical application of the Toll-like receptor 7/8 (TLR7/8) agonist Resiquimod...
March 1, 2017: Disease Models & Mechanisms
Anant Khositseth, Wasana Prangwatanagul, Kanchana Tangnararatchakit, Soamarat Vilaiyuk, Nantawan Su-Angka
OBJECTIVES: To evaluate cardiac structure and function in paediatric SLE patients without clinical evidence of cardiovascular disease in active and inactive diseases. METHODS: Patients aged ≤20 years who fulfilled the diagnostic criteria of active SLE underwent transthoracic echocardiography to evaluate cardiac structure and function, and were then followed up echocardiographically every 3-4 months until SLE disease was inactive. Patients with heart failure, myocarditis, pericarditis, endocarditis, coronary artery disease, or abnormal structural heart disease were excluded...
February 3, 2017: Clinical and Experimental Rheumatology
Sophie Mavrogeni, George Markousis-Mavrogenis, Loukia Koutsogeorgopoulou, Theodoros Dimitroulas, Konstantinos Bratis, George D Kitas, Petros Sfikakis, Maria Tektonidou, Georgia Karabela, Efthymios Stavropoulos, Gikas Katsifis, Kyriaki A Boki, Anastasia Kitsiou, Vasiliki Filaditaki, Elias Gialafos, Sotiris Plastiras, Vasiliki Vartela, Genovefa Kolovou
BACKGROUND-AIM: Cardiac involvement at diagnosis of connective tissue disease (CTD) has been described by echocardiography. We hypothesized that cardio-vascular magnetic resonance (CMR) detects occult lesions at CTD diagnosis. PATIENTS-METHODS: CMR was performed early after diagnosis in 78 treatment-naïve CTDs (aged 43±11, 59F/19M) without cardiac involvement [5 Takayasu arteritis (TA), 4 Churg Strauss syndrome (CSS), 5 Wegener granulomatosis (WG), 16 systemic lupus erythematosus (SLE), 12 rheumatoid arthritis (RA), 8 mixed connective tissue diseases (MCTD), 12 ankylosing spondylitis (AS), 3 polymyalgia rheumatica (PMR), 8 systemic sclerosis (SSc) and 5 dermatomyositis (DM)]...
February 1, 2017: International Journal of Cardiology
Raúl Castellanos-Moreira, Sebastián Rodríguez-García, Teresa López-Sobrino, Aina Capdevila, Sergio Prieto-González, Gerard Espinosa
No abstract text is available yet for this article.
January 25, 2017: Revista Española de Cardiología
Jakub Lagan, Matthias Schmitt, Christopher A Miller
Cardiac magnetic resonance (CMR) has changed the management of suspected viral myocarditis by providing a 'positive' diagnostic test and has lead to new insights into myocardial involvement in systemic inflammatory conditions. In this review we analyse the use of CMR tissue characterisation techniques across the available studies including T2 weighted imaging, early gadolinium enhancement, late gadolinium enhancement, Lake Louise Criteria, T2 mapping, T1 mapping and extracellular volume assessment. We also discuss the use of multiparametric CMR in acute cardiac transplant rejection and a variety of inflammatory conditions such as sarcoidosis, systemic lupus erythrematous, rheumatoid arthritis and systemic sclerosis...
January 27, 2017: International Journal of Cardiovascular Imaging
Lily Sh Lim, Eleanor Pullenayegum, Lillian Lim, Dafna Gladman, Brian Feldman, Earl Silverman
Objectives 1) To determine the longitudinal damage trajectory of patients with childhood-onset SLE (cSLE). 2) To identify baseline and disease course predictors of damage trajectory. Methods This is a retrospective inception cohort. Longitudinal pediatric-age data was obtained from a cSLE research database while adult-age data was obtained from either a research database or patients' charts. Baseline factors were tested as predictors. Time-varying factors were lagged 6 to 24 months before a visit for testing their predictive effects...
January 24, 2017: Arthritis Care & Research
Guillemette Thomas, Fleur Cohen Aubart, Laurent Chiche, Julien Haroche, Miguel Hié, Baptiste Hervier, Nathalie Costedoat-Chalumeau, Karine Mazodier, Mikael Ebbo, Philippe Cluzel, Nadège Cordel, David Ribes, Jean Chastre, Nicolas Schleinitz, Véronique Veit, Jean-Charles Piette, Jean-Robert Harlé, Alain Combes, Zahir Amoura
OBJECTIVE: Cardiac involvement during systemic lupus erythematosus (SLE) may include the pericardium, myocardium, valvular tissue, and coronary arteries. The aim of this study was to describe the clinical, biological, and radiological presentation of lupus myocarditis (LM) as well as the treatment response and longterm outcomes. METHODS: We conducted a multicentric retrospective study of LM from January 2000 to May 2014. RESULTS: Twenty-nine patients (3 men and 26 women) fulfilled the inclusion criteria (median age at the diagnosis of SLE: 30 yrs, range 16-57)...
January 2017: Journal of Rheumatology
Gabriela Nunes Leal, Maria de Fátima Diniz, Juliana Brunelli, Alessandro C Lianza, Adriana M E Sallum, Clovis A Silva
No abstract text is available yet for this article.
September 2016: Revista da Associação Médica Brasileira
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)...
December 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...
July 20, 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...
January 2017: 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
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