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Pancarditis as initial presentation of systemic lupus erythematosus
International Journal of Cardiology
|December 7, 2002
Summary
Systemic lupus erythematosus (SLE) can cause pancarditis, a rare initial presentation. High-dose corticosteroids effectively treated cardiac dysfunction and vegetations in a culture-negative endocarditis case.
Area of Science:
- Cardiology
- Rheumatology
- Immunology
Background:
- Systemic lupus erythematosus (SLE) frequently involves the heart, but clinically significant lesions are uncommon.
- Pancarditis as the initial presentation of SLE has not been previously reported.
Observation:
- A rare case of SLE presented with pancarditis, including culture-negative endocarditis, reversible left ventricular dysfunction, and mild pericardial effusion.
- The patient exhibited no signs of infective endocarditis.
Findings:
- Treatment with high-dose corticosteroids led to significant improvement in cardiac contractile function.
- Mitral valve vegetations resolved completely within three months of steroid therapy.
Implications:
- SLE should be considered in cases of pancarditis with culture-negative endocarditis.
- Early corticosteroid treatment can effectively manage cardiac manifestations in SLE, including reversible LV dysfunction and vegetations.