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Dilated cardiomyopathy: An unusual and severe condition in juvenile systemic lupus erythematosus

Kenza Bouayed1, Tiaaza Faid1, Asmaa Sakhi1

  • 1Department of Pediatric Rheumatology and Internal Medicine, A. Harouchi Mother-Child Hospital, Ibn Rochd University Hospital, 92957Hassan II University, Casablanca, Morocco.

Lupus
|March 21, 2022
PubMed

Insights

Systemic juvenile lupus erythematosus can cause rare dilated cardiomyopathy. This case shows full recovery with timely treatment and monitoring, highlighting the importance of cardiac evaluation.

Area of Science:

  • Pediatric Rheumatology
  • Cardiology

Background:

  • Systemic juvenile lupus erythematosus (sJLE) can manifest with cardiac involvement, though dilated cardiomyopathy is an uncommon complication.
  • While pericarditis and endocarditis are more frequent, this report focuses on a rare instance of dilated cardiomyopathy in a child with sJLE.

Observation:

  • A 7-year-old girl presented with constitutional symptoms, alopecia, and serological markers of lupus.
  • Clinical examination revealed signs of heart failure, including dyspnea, tachycardia, and hypotension, with imaging confirming significantly reduced left ventricular ejection fraction.

Findings:

  • The patient was diagnosed with systemic lupus erythematosus-related dilated cardiomyopathy and treated with standard heart failure therapy, corticosteroids, and hydroxychloroquine.
  • She experienced a concurrent episode of macrophage activation syndrome, which was successfully managed with methylprednisolone.

Implications:

  • Complete recovery of cardiac function was observed within four months of treatment initiation.
  • This case underscores the critical need for echocardiography in children with juvenile lupus presenting with any cardiac symptoms, given the potential for severe but reversible cardiomyopathy.
Abstract

Keywords:
Systemic lupus erythematosuscardiomyopathycardiovascular diseasepediatrics

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