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首页> 外文期刊>Journal of Clinical and Diagnostic Research >Myocarditis with Cardiac Failure: Initial Manifestation of Systemic Lupus Erythematosus
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Myocarditis with Cardiac Failure: Initial Manifestation of Systemic Lupus Erythematosus

机译：心肌炎伴心脏衰竭：系统性红斑狼疮的最初表现

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Cardiac involvement is very rare in Systemic Lupus Erythematosus (SLE). Pericarditis is the leading cardiovascular manifestation inSLE followed by endocarditis, conduction abnormality, coronary artery disease and myocardial dysfunction. Myocardial dysfunctionis 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 youngboy who presented to us with features of congestive heart failure subsequently diagnosed to be secondary to fulminant lupusmyocarditis. Despite intensive management, the child ultimately succumbed. His echocardiography revealed dilated left ventriclewith an Ejection Fraction (EF) of 18.2%. A positive titre of p-ANCA was also seen in this case. Although, ANCA positivity hasbeen shown as a bad prognostic marker for lupus nephritis, its association with lupus myocarditis is still unknown. Decongestivemeasures along with immunosuppressant drugs remain the preferred treatment. This case highlights the protean presentation ofSLE in the form of lupus myocarditis leading to congestive heart failure that merits an urgent intervention because of the potentiallydevastating consequences.
机译：系统性红斑狼疮（SLE）中很少有心脏受累。心包炎是SLE的主要心血管表现，其次是心内膜炎，传导异常，冠状动脉疾病和心肌功能障碍。心肌功能障碍通常是亚临床的，但可能很少发展为心室功能障碍，心源性休克或严重的充血性心力衰竭。导致心力衰竭的心肌炎是儿童狼疮的一种非常罕见的表现。我们介绍了一个四岁半的年轻男孩，他表现出充血性心力衰竭的特征，随后被诊断为暴发性狼疮性心肌炎继发。尽管进行了强化管理，孩子还是屈服了。他的超声心动图显示左心室扩张，射血分数（EF）为18.2％。在这种情况下，还可以看到p-ANCA的阳性滴度。尽管ANCA阳性已被证明是狼疮性肾炎的不良预后指标，但其与狼疮性心肌炎的相关性仍未知。消肿措施与免疫抑制剂仍然是首选治疗方法。该病例突出显示了狼疮性心肌炎形式的SLE的蛋白质表现，导致充血性心力衰竭，由于其潜在的破坏性后果，值得紧急干预。

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