Successful treatment of chronic lupus myocarditis with prednisolone and mizoribine

Akazawa, Satoru; Ichinose, Kunihiro; Origuchi, Tomoki; Kawashiri, Shin‐ya; Iwamoto, Naoki; Fujikawa, Keita; Aramaki, Toshiyuki; Kamachi, Makoto; Arima, Kei; Tamai, Mami; Nakamura, Hideki; Ida, Hiroaki; Kawakami, Atsushi; Eguchi, Katsumi

doi:10.3109/s10165-010-0326-2

Cited by 4 publications

(1 citation statement)

References 9 publications

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“…This concern, though, seems to have been unfounded, as many large studies have shown that GC benefits from viral myocarditis with or without other immunosuppressants (113)(114)(115). Differently, the benefit of GC for autoimmune myocarditis is considered definite since it not only controls the severity of autoimmune diseases but also protects the heart through a pluripotent mechanism (65,116,117). A casecontrol study of 811 patients showed that early glucocorticoid treatment significantly reduced the in-hospital mortality of patients with thyroid storm (118).…”

Section: Immunomodulatory Therapymentioning

confidence: 99%

Focus on Autoimmune Myocarditis in Graves' Disease: A Case-Based Review

Wang

Leng

et al. 2021

Front. Cardiovasc. Med.

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The manifestations of hyperthyroidism-related myocardial damage are multitudinous, including arrhythmia, dilated cardiomyopathy, valvular diseases, and even cardiogenic shock. Acute myocarditis induced by thyrotoxicosis had been reported in a few studies. However, attention on its prevalence and underlying mechanisms is sorely lacking. Its long-term harm is often ignored, and it may eventually develop into dilated cardiomyopathy and heart failure. We report a case of Graves' disease with a progressive elevation of hypersensitive cardiac troponin-I at several days after discontinuation of the patient's anti-thyroid drugs. Cardiac magnetic resonance imaging (CMRI) showed inflammatory edema of some cardiomyocytes (stranded enhanced signals under T2 mapping), myocardial necrosis (scattered enhanced signals under T1 late gadolinium enhancement) in the medial and inferior epicardial wall, with a decreased left ventricular systolic function (48%), which implied a possibility of acute myocarditis induced by thyrotoxicosis. The patient was then given a transient glucocorticoid (GC) treatment and achieved a good curative effect. Inspired by this case, we aim to systematically elaborate the pathogenesis, diagnosis, and treatment of hyperthyroidism-induced autoimmune myocarditis. Additionally, we emphasize the importance of CMRI and GC therapy in the diagnosis and treatment of hyperthyroidism-related myocarditis.

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Section: Immunomodulatory Therapymentioning

confidence: 99%

Focus on Autoimmune Myocarditis in Graves' Disease: A Case-Based Review

Wang

Leng

et al. 2021

Front. Cardiovasc. Med.

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The use of glucocorticoids in Systemic Lupus Erythematosus. After 60years still more an art than science

Luijten¹,

Fritsch-Stork²,

Bijlsma³

et al. 2013

Autoimmunity Reviews

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Rare Presentation of Lupus Myocarditis With Acute Heart Failure—A Case Report

Malhotra¹,

Chua

Kodumuri

et al. 2016

American Journal of Therapeutics

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Systemic lupus erythematosus is an autoimmune disease with diffuse organ involvement. The cardiac complications include pericarditis, myocarditis, pulmonary hypertension, coronary vasculitis, and Libman-Sacks endocarditis. Symptomatic lupus myocarditis presenting with left ventricular dysfunction, acute heart failure, and pulmonary edema, although rare, is a life-threatening complication. We report the occurrence of acute lupus myocarditis in a 38-year-old postpartum female who had a cesarean section a week before presentation for preeclampsia. Initially she was managed for pneumonia but later found to have acute pericarditis and myocarditis related to systemic lupus erythematosus. She had a complicated hospital course including acute respiratory failure and cardiogenic shock. She was started on pulse dose steroids besides the treatment for heart failure and had a dramatic improvement within days.

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Successful treatment of chronic lupus myocarditis with prednisolone and mizoribine

Cited by 4 publications

References 9 publications

Focus on Autoimmune Myocarditis in Graves' Disease: A Case-Based Review

Focus on Autoimmune Myocarditis in Graves' Disease: A Case-Based Review

The use of glucocorticoids in Systemic Lupus Erythematosus. After 60years still more an art than science

Rare Presentation of Lupus Myocarditis With Acute Heart Failure—A Case Report

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