Case Reports in Rheumatology / 2019 / Article / Tab 2

Case Report

Systemic Lupus Erythematosus Presenting as Myopericarditis with Acute Heart Failure: A Case Report and Literature Review

Table 2

Literature review of 9 case reports and one case series reporting heart failure as the presenting sign of systemic lupus erythematosus.

Diagnostic studies and workupTreatmentOutcome
Case reportGenderAgePertinent historySigns & symptoms at presentationOther manifestations of autoimmune diseaseCXRECGLabsInitial ECHO (EF%)SteroidAZACYPPlasmapheresis/IVIGClinicalECHO (EF%)

Ashrafi, 2011M35None3 months progressive SOB, lower edema swellingMyositisDCMNSR with nonsustained VTAnti-Ro, anti-La, ANA (1 : 640)16YNNYWorseningNot reported

Baquero, 2011F22FH: CRESTDOE, JVD, lower extremity edemaLupus nephritisBilateral pleural effusionsSinus tachycardia with nonspecific T wave changesESR 71, ANA (1:64), ds-DNA, anti-Smith, low C3, C415YNYNImproved60%

Sandrasegaran, 1991F42NoneFever x 1 weekNoneCongestion, white-outMild ST depressions in anterior-lateral leadsAnemia, ESR 150; ANA + (1 : 100); lupus anticoagulant, low C3/C4, anti-RoSevere, no EF%YNNNImprovedReported as improved; no number given

Frustaci, 1996M38NoneFever, palpitations, SOB, weakness x 2 weekMucosal ulcersMod pulmonary congestionDiffuse ST-T abnormalitiesAnemia, ESR 120;45YNNNNone given65%

Routray, 2004F36NoneDyspnea, orthopnea, tachycardiaNonePulmonary congestion, left pleural effusionDiffuse ST-T abnormalitiesESR 80; ANA + (1 : 40); anti-ds-DNA +35YNNNImproved45%, 10 day follow-up

Hoang, 2015F26NoneCough, dyspnea, weight loss x 1 monthNoneBilateral lower lobe patchy infiltratesNoneAnemia, AKI, anti-Ro,35YNNNImproved60%

Woo, 2009F27NoneDyspnea, orthopnea x 2 weeksLupus nephritisCardiomegaly, interstitial pulmonary edemaNoneAnemia; ESR 33; ANA +; low C3/C4; ds-DNA+, anti-La30YNY, 1 da yNImproved55%

Usalan, 2007F32NonePalpitations, malaise, dyspnea, orthopnea x 10 daysLupus nephritis, hemolysisCardiomegaly, pulmonary congestion bilaterallySinus tachycardia with nonspecific ST-T wave changesAnemia, ESR 90, hemolysis (Coombs direct +), ANA (1 : 160), ds-DNA, low C3/C4, anti-cardiolipin24YNNNImproved55%

van der Laan- Baalbergen, 2009F19ArthralgiasPancytopenia, feverProteinuriaCardiomegaly, pleural effusionNoneAnemia, ANA, ds-DNA, anti-Smith, anti-cardiolipin, low C3/C4Hypokinesis, pericardial effusion, EF 25%YNYYImproved
F40DVTDyspnea, alopecia, rash, weakness progressing to cardiogenic shockRenal Bx: lupus nephritisNot reportedNoneANA, ds-DNA, Jo, Sm, SSA, SSB, ENA, aCL, cardiac biopsy positive23YYYNImproved55%

DCM: dilated cardiomyopathy; NSR: normal sinus rhythm; ECHO: transthoracic cardiac ultrasound; EF%: left ventricular ejection fraction; M: male; F: female; Y: yes; N: no; SOB: shortness of breath; DVT: deep vein thrombosis; AZA: azathioprine; CYP: cyclophosphamide; CXR: chest X-ray; Bx: biopsy; DOE: dyspnea on exertion; JVD: jugular vein distention.

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