451. Myocarditis of mixed connective tissue disease: favourable outcome after intravenous pulsed cyclophosphamide.
- Author
-
Hammann C, Genton CY, Delabays A, Bischoff Delaloye A, Bogousslavsky J, and Spertini F
- Subjects
- Adult, Biopsy, Diagnosis, Differential, Echocardiography, Doppler, Female, Follow-Up Studies, Heart Ventricles diagnostic imaging, Heart Ventricles pathology, Heart Ventricles physiopathology, Humans, Injections, Intravenous, Mixed Connective Tissue Disease diagnosis, Mixed Connective Tissue Disease drug therapy, Myocarditis diagnosis, Myocarditis drug therapy, Stroke Volume, Tomography, X-Ray Computed, Cyclophosphamide administration & dosage, Immunosuppressive Agents administration & dosage, Mixed Connective Tissue Disease complications, Myocarditis etiology
- Abstract
A 30-year-old woman with mixed connective tissue disease was admitted with Wernicke's aphasia and progressive dyspnoea with chest pain. Multiple brain infarcts on a computed tomographic scan were compatible with a thromboembolic aetiology. Echocardiography showed marked hypokinesia of the posterior wall, biventricular dilatation and a decreased left-ventricle ejection fraction (40%). A diagnosis of myocarditis was made on myocardial biopsies disclosing interstitial lymphocytic infiltrates and myocardial fibre necrosis. A treatment with steroids and monthly pulsed cyclophosphamide was introduced. The heart function rapidly improved as assessed by a left-ventricle ejection fraction of 55% and remained stable 17 months thereafter.
- Published
- 1999
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