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Age/sex | Suspected etiology | Factors supporting diagnosis of sweet syndrome | Factors supporting diagnosis of myocarditis | Therapy administered | Outcome | Author |
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40/F | Mesalamine (drug induced) | Edematous and erythematous plaques with some central blistering and erosions, located on the arm, neck, and palate. | Fever, acute shortness of breath, and chest pain. | Topical clobetasol cream, 6 weeks of indomethacin + colchicine, and mesalamine discontinued | Resolution of myopericarditis within 20 days; no skin lesions at 6 weeks of follow-up | Shabtaie et al. [14] |
Biopsy: inflammatory infiltrate of the dermis, consisting of neutrophils and leukocytoclasis. | Troponin T 0.12 ng/mL (elevated) and CRP 184 mg/L (elevated). |
ECG: diffuse ST elevations. |
Cardiac MRI: diffuse pericardial enhancement and edema. |
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64/F | Myelodysplastic syndrome | Movable, tender, erythematous, cutaneous nodule of 1.5 cm × 1.5 cm at the inner aspect of the right lower leg. Skin biopsy demonstrated acute febrile neutrophilic dermatosis. | Clinically, the patient had symptoms consistent with myocarditis. | Prednisolone 30 mg/day | Death secondary to sudden cardiac arrest 3 days after presentation | Shimizu [15] |
Cardiac MRI: a small amount of pericardial effusion and slightly dilated LA. Postmortem heart biopsy: perivascular and myocardial neutrophil infiltration. |
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41/M | Idiopathic | Painful erythematous papules and plaques on the nape, neck, shoulders, and arms, as well as painful hyperpigmented subcutaneous nodules. Skin biopsy: subepithelial edema, dermal inflammatory infiltrate with polymorphonuclear predominance and absence of vasculitis. | EKG changes and elevated cardiac biomarkers. | Oral prednisolone 1 mg/kg/day | Complete resolution of symptoms within 4 days of presentation | Graça-Santos et al. [16] |
Cardiac MRI: patchy subepicardial enhancement and slight edema in the inferolateral wall. |
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42/M | G-CSF administration | “New skin lesions compatible with sweet syndrome reactivation.” Sweet syndrome had previously been confirmed on biopsy in an episode 1 year prior. | Myocardial biopsy revealed interstitial edema and perivascular neutrophil infiltrate. Additionally, an echocardiogram with new LV systolic dysfunction and CXR with enlarged cardiac silhouette. | Hydrocortisone 1 mg/kg/day, with noninvasive ventilation and IV diuretics | Clinical parameters, invasive monitoring values, and ventricular function normalized at 48 hours | Díaz et al. [17] |
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