Cytomegalovirus myocarditis in a patient with systemic lupus erythematosus (SLE) successfully treated with ganciclovir
Myocarditis is an inflammatory disease of the myocardium. Viruses, such as enterovirus, adenovirus, parvovirus B19, HHV6 or cytomegalovirus (CMV) and autoimmune diseases are recognized causes of myocarditis. We describe the clinical case of a young Indian woman with SLE and a concomitant acute CMV r...
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doaj-0c54f541c68a46ffb56ee89b4d5fe8292021-07-02T11:49:51ZengElsevierIDCases2214-25092018-01-011246Cytomegalovirus myocarditis in a patient with systemic lupus erythematosus (SLE) successfully treated with ganciclovirLavinia Maria Saraca0Ludovico Lazzari1Cinzia di Giuli2Alessandro Lavagna3Paola Mezzetti4Daniela Bovelli5Enrico Boschetti6Daniela Francisci7Infectious Diseases Clinic, University Hospital “S. Maria”, University of Perugia, Terni, ItalyDepartment of Cardiology, University Hospital “S. Maria”, University of Perugia, Terni, ItalyInfectious Diseases Clinic, University Hospital “S. Maria”, Terni, ItalyInfectious Diseases Clinic, University Hospital “S. Maria”, Terni, ItalyDepartment of Cardiology, University Hospital “S. Maria”, Terni, ItalyDepartment of Cardiology, University Hospital “S. Maria”, Terni, ItalyDepartment of Cardiology, University Hospital “S. Maria”, University of Perugia, Terni, ItalyInfectious Diseases Clinic, University Hospital “S. Maria”, University of Perugia, Terni, Italy; Corresponding author at: University of Perugia, Infectious Diseases Clinic, University Hospital “S. Maria”, Via Tristano di Joannuccio, 1 05100 Terni, Italy.Myocarditis is an inflammatory disease of the myocardium. Viruses, such as enterovirus, adenovirus, parvovirus B19, HHV6 or cytomegalovirus (CMV) and autoimmune diseases are recognized causes of myocarditis. We describe the clinical case of a young Indian woman with SLE and a concomitant acute CMV related myocarditis with favourable outcome after ganciclovir therapy.CMV myocarditis may range from being a subclinical infection with incidental findings on ECG to a life threating presentation. There are no trials demonstrating the efficacy of antiviral therapy in myocarditis. Case series of patients with CMV myocarditis have reported an excellent clinical outcome after antiviral agents. Lupus Myocarditis (LM) is more prevalent in young females. There are no specific ECG or echocardiographic signs. Treatment strategies of LM are based on corticosteroids, immunosuppressive agents and cardiovascular support, usually with a favorable prognosis, but LM often lead to a severe clinical picture, with mortality of 10.3%. Endomyocardial biopsy (EBM) is recommended as the gold standard but it is very underused in clinical practice, It should be performed in a specialized center but there are concerns on lack of specificity, low negative predictive value, risk of complication, and sampling errors due to the focal nature of myocarditis. Both SLE and CMV are potentially responsible of acute myocarditis. In our knowledge, CMV myocarditis with SLE was described in only one other patient. The initiation of antiviral therapy improved the clinical picture and, in our opinion, it is mandatory when CMV related life threating conditions develop. Keywords: Myocarditis, Cytomegalovirus, Systemic lupus erythematosushttp://www.sciencedirect.com/science/article/pii/S2214250918300040 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Lavinia Maria Saraca Ludovico Lazzari Cinzia di Giuli Alessandro Lavagna Paola Mezzetti Daniela Bovelli Enrico Boschetti Daniela Francisci |
spellingShingle |
Lavinia Maria Saraca Ludovico Lazzari Cinzia di Giuli Alessandro Lavagna Paola Mezzetti Daniela Bovelli Enrico Boschetti Daniela Francisci Cytomegalovirus myocarditis in a patient with systemic lupus erythematosus (SLE) successfully treated with ganciclovir IDCases |
author_facet |
Lavinia Maria Saraca Ludovico Lazzari Cinzia di Giuli Alessandro Lavagna Paola Mezzetti Daniela Bovelli Enrico Boschetti Daniela Francisci |
author_sort |
Lavinia Maria Saraca |
title |
Cytomegalovirus myocarditis in a patient with systemic lupus erythematosus (SLE) successfully treated with ganciclovir |
title_short |
Cytomegalovirus myocarditis in a patient with systemic lupus erythematosus (SLE) successfully treated with ganciclovir |
title_full |
Cytomegalovirus myocarditis in a patient with systemic lupus erythematosus (SLE) successfully treated with ganciclovir |
title_fullStr |
Cytomegalovirus myocarditis in a patient with systemic lupus erythematosus (SLE) successfully treated with ganciclovir |
title_full_unstemmed |
Cytomegalovirus myocarditis in a patient with systemic lupus erythematosus (SLE) successfully treated with ganciclovir |
title_sort |
cytomegalovirus myocarditis in a patient with systemic lupus erythematosus (sle) successfully treated with ganciclovir |
publisher |
Elsevier |
series |
IDCases |
issn |
2214-2509 |
publishDate |
2018-01-01 |
description |
Myocarditis is an inflammatory disease of the myocardium. Viruses, such as enterovirus, adenovirus, parvovirus B19, HHV6 or cytomegalovirus (CMV) and autoimmune diseases are recognized causes of myocarditis. We describe the clinical case of a young Indian woman with SLE and a concomitant acute CMV related myocarditis with favourable outcome after ganciclovir therapy.CMV myocarditis may range from being a subclinical infection with incidental findings on ECG to a life threating presentation. There are no trials demonstrating the efficacy of antiviral therapy in myocarditis. Case series of patients with CMV myocarditis have reported an excellent clinical outcome after antiviral agents. Lupus Myocarditis (LM) is more prevalent in young females. There are no specific ECG or echocardiographic signs. Treatment strategies of LM are based on corticosteroids, immunosuppressive agents and cardiovascular support, usually with a favorable prognosis, but LM often lead to a severe clinical picture, with mortality of 10.3%. Endomyocardial biopsy (EBM) is recommended as the gold standard but it is very underused in clinical practice, It should be performed in a specialized center but there are concerns on lack of specificity, low negative predictive value, risk of complication, and sampling errors due to the focal nature of myocarditis. Both SLE and CMV are potentially responsible of acute myocarditis. In our knowledge, CMV myocarditis with SLE was described in only one other patient. The initiation of antiviral therapy improved the clinical picture and, in our opinion, it is mandatory when CMV related life threating conditions develop. Keywords: Myocarditis, Cytomegalovirus, Systemic lupus erythematosus |
url |
http://www.sciencedirect.com/science/article/pii/S2214250918300040 |
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