Severe lupus with infectious thyroiditis and lethal cardiomyopathy

M Macro1, E Le Gangneux, E Gallet

  • 1Department of Rheumatology, CHRU Côte de Nacre, Caen, France.

Insights

Systemic lupus erythematosus (SLE) can cause rare heart complications like cardiomyopathy and thrombosis. This case highlights the diagnostic value of cardiac imaging and biopsy in managing these severe SLE manifestations.

Area of Science:

  • Cardiology
  • Rheumatology
  • Internal Medicine

Background:

  • Systemic lupus erythematosus (SLE) is a chronic autoimmune disease with diverse clinical manifestations.
  • Cardiac involvement in SLE, such as lupus cardiomyopathy, is uncommon.
  • Intracavitary thrombosis is a rare but serious complication in SLE patients.

Observation:

  • A patient with active SLE presented with rapidly progressive cardiomyopathy.
  • The cardiomyopathy's fatal progression was complicated by an intracavitary thrombus.
  • The patient also developed acute suppurative thyroiditis, a previously undescribed association with SLE.

Findings:

  • Cardiac echocardiography and endomyocardial biopsy were crucial for diagnosing lupus myocarditis.
  • These diagnostic tools aided in adjusting the patient's therapeutic regimen.
  • The co-occurrence of acute suppurative thyroiditis and SLE was noted.

Implications:

  • This case underscores the importance of cardiac monitoring in SLE patients.
  • Early diagnosis and management of cardiac complications in SLE are vital.
  • The association with acute suppurative thyroiditis warrants further investigation in SLE patients.

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