Myocarditis in mixed connective tissue disease

Whitlow, Patrick L.; Gilliam, James N.; Chubick, Andrew; Ziff, Morris

doi:10.1002/art.1780230706

Cited by 28 publications

(3 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

Section: Pathogenesis and Cardiac Involvement: Mctdmentioning

confidence: 99%

“…The pathophysiologic mechanisms causing cardiac involvement in MCTD are partly shared with myositis, and myocarditis has been reported in occasional patients (Whitlow et al, 1980). 18 However, there are some distinct differences compared to myositis; firstly pericarditis seems to be a more common manifestation in patients with MCTD and secondly the most prominent cardiac problem in patients with MCTD is pulmonary hypertension. 16 From autopsy studies it was demonstrated that the pulmonary hypertension was associated with intimal proliferation of small pulmonary arteries and arterioles and smooth muscle hypertrophy with only sporadic lymphocytic infiltration in the lungs.…”

Section: Pathogenesis and Cardiac Involvement: Mctdmentioning

confidence: 99%

See 1 more Smart Citation

Cardiac involvement in autoimmune myositis and mixed connective tissue disease

Lundberg

2005

Lupus

View full text Add to dashboard Cite

The clinical cardiac manifestations most frequently reported in idiopathic inflammatory myopathies, myositis, are congestive heart failure, conduction abnormalities, that may lead to complete heart block and coronary artery disease. Although clinically overt cardiac involvement is rarely reported in myositis patients, subclinical manifestations are frequently observed and are predominated by conduction abnormalities and arrhythmias detected by ECG. Furthermore, cardiovascular manifestations constitute a major cause of death in myositis, thus cardiac involvement maybe overlooked in these patients. Also children with juvenile dermatomyositis may develop cardiac involvement although the frequency seems to be low. The underlying pathophysiologic mechanisms that may cause cardiac manifestations could involve myocarditis and coronary artery disease as well as involvement of the small vessels of the myocardium. In patients with mixed connective tissue disease (MCTD) clinically significant cardiac involvement is also rare, the most frequently reported manifestations being pericarditis and pulmonary hypertension, the latter often attributable to small vessel disease, and often a prognostic unfavourable manifestation.

show abstract

Section: Pathogenesis and Cardiac Involvement: Mctdmentioning

confidence: 99%

Section: Pathogenesis and Cardiac Involvement: Mctdmentioning

confidence: 99%

Cardiac involvement in autoimmune myositis and mixed connective tissue disease

Lundberg

2005

Lupus

View full text Add to dashboard Cite

show abstract

“…Whitlow et al 13 described a young black woman with clinical and serologic features of MCTD who developed myocarditis, congestive heart failure, and ventricular ectopic activity with high titer of antibody to U1 ribonucleoprotein (U1RNP). The combination of features is the core of criteria by Sharp, 20 Alarcón-Segovia and Villareal, 21 and Khan and Appeboom 22 in the presence of synovitis.…”

Section: Discussionmentioning

confidence: 99%

Mixed connective tissue disease complicated by heart failure in Ile-Ife, Nigeria: management challenges in a resource-limited economy

Adewuya¹,

Adebayo²,

Ajibade³

et al. 2018

IMCRJ

View full text Add to dashboard Cite

BackgroundMixed connective tissue disease (MCTD; also known as Sharp’s syndrome) is a rare autoimmune inflammatory disorder characterized by high titer of U1 ribonucleoprotein (U1RNP) antibody and clinical and serological overlap of systemic lupus erythematosus, systemic sclerosis, and polymyositis. The diagnosis is based on clinical and serological factors in criteria such as Alarcon-Segovia, Khan, Kusakawa, and Sharps. Cardiac disease can be a complication of connective tissue disease (CTD). There are few reports in Africa.AimsTo present MCTD as underlying cause of heart failure with reduced ejection fraction and highlight challenges of investigations and treatment.ObjectivesTo highlight the first case in our center and discuss the cardiac, respiratory, and rheumatologic management.Patient and methodsWe present a 52-year-old woman with 3 weeks history of productive cough with whitish sputum, severe dyspnea, orthopnea, paroxysmal nocturnal dyspnea, right sided abdominal pain, leg swellings, a one year history of recurrent fever, Raynaud’s phenomenon, small joint swellings and deformities with pain in both hands.ResultsOn examination there was microstomia, tethered forehead and lower eyelid skin, tender swelling of the interphalangeal joints and arthritis mutilans. Laboratory findings showed estimated glomerular filtration rate <60 mL/kg/min/1.73 m2, U1RNP antibody levels were eight times upper limit of normal, elevated rheumatoid factor, speckled antinuclear antibody pattern, negative anticentromere antibody, anti Scl-70 and anticyclic citrullinated peptide. Chest X-ray/CT revealed pulmonary fibrosis. Echocardiography findings showed reduced ejection fraction of 40%, elevated pulmonary arterial pressure at rest of 60.16 mmHg. The patient showed improvement on antifailure drugs, but prednisolone was stopped for sudden reversal of previously controlled stage 2 hypertension (HTN), and the patient was discharged in a stable condition. Difficulties ensued in obtaining prompt definite results due to the unavailability of serologic tests in the hospital, and the tests were done outside the state and country.ConclusionIdentifying MCTD is critical, especially in patients requiring steroids that may worsen systemic HTN and heart failure. There is a need to have definitive investigative facilities for such patients in hospitals.

show abstract

ECG Abnormalities in Polymyositis

Stern¹

1984

Arch Intern Med

View full text Add to dashboard Cite

Myocarditis in mixed connective tissue disease

Cited by 28 publications

References 20 publications

Cardiac involvement in autoimmune myositis and mixed connective tissue disease

Cardiac involvement in autoimmune myositis and mixed connective tissue disease

Mixed connective tissue disease complicated by heart failure in Ile-Ife, Nigeria: management challenges in a resource-limited economy

ECG Abnormalities in Polymyositis

Contact Info

Product

Resources

About