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Orbital polymyositis and giant cell myocarditis
M L Leib1, J G Odel, M J Cooney
1Orbit and Plastics Service, Edward S. Harkness Eye Institute, Columbia-Presbyterian Medical Center, New York, NY 10032.
Ophthalmology
|May 1, 1994
Summary
Orbital polymyositis can be linked to giant cell myocarditis, a rare but serious condition. Early diagnosis and cardiac transplantation can improve outcomes for survivors of this typically fatal syndrome.
Area of Science:
- Ophthalmology
- Cardiology
- Pathology
Background:
- Orbital polymyositis is an inflammatory condition affecting eye muscles.
- Giant cell myocarditis is a rare and often fatal cardiac disease.
- The association between these two conditions is seldom reported.
Observation:
- A 22-year-old woman presented with bilateral orbital inflammation unresponsive to antibiotics.
- Clinical examination revealed limited extraocular movements, ptosis, and proptosis.
- Orbital CT showed extraocular muscle swelling, leading to a diagnosis of orbital polymyositis.
Findings:
- The patient initially improved with steroid treatment for orbital polymyositis.
- She later developed cardiogenic shock, with endomyocardial biopsy revealing giant cell myocarditis.
- Successful emergent cardiac transplantation was performed, with a positive long-term outcome.
Implications:
- This case highlights the importance of suspecting giant cell myocarditis in patients with orbital polymyositis.
- Screening for cardiac involvement, including echocardiography and endomyocardial biopsy, is crucial.
- Timely diagnosis and intervention, such as cardiac transplantation, can be life-saving.