Myocardite auto-immune dans un pays à faibles ressources diagnostiques : l’épreuve thérapeutique a-t-elle une place ?

The aim was to report a case of auto-immune myocarditis and to clarify the role of therapeutic testing in its management. We report the case of a 66-year-old man who had no systemic signs. He presented with congestive heart failure due to myocarditis and severe left ventricular systolic impairment associated with severe pulmonary hypertension. Serum protein electrophoresis revealed oligoclonal hypergammaglobulinemia. The auto-immune work-up was positive, with a nucleolar and speckled AAN, and positive anti-U1RNP and anti-Scl 70. The course was marked by the disappearance of pulmonary hypertension and an improvement in ventricular kinetics and ejection fraction from 15% to 52% after treatment with an anti-endothelin agent combined with an immunosuppressant and corticosteroid therapy. In a country with few diagnostic resources, the therapeutic test could be useful in improving the patient’s condition. [ABSTRACT FROM AUTHOR]