Myocarditis of mixed connective tissue disease: favourable outcome after intravenous pulsed cyclophosphamide

Clin Rheumatol. 1999;18(1):85-7. doi: 10.1007/s100670050062.

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.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Biopsy
  • Cyclophosphamide / administration & dosage*
  • Diagnosis, Differential
  • Echocardiography, Doppler
  • Female
  • Follow-Up Studies
  • Heart Ventricles / diagnostic imaging
  • Heart Ventricles / pathology
  • Heart Ventricles / physiopathology
  • Humans
  • Immunosuppressive Agents / administration & dosage*
  • Injections, Intravenous
  • Mixed Connective Tissue Disease / complications*
  • Mixed Connective Tissue Disease / diagnosis
  • Mixed Connective Tissue Disease / drug therapy
  • Myocarditis / diagnosis
  • Myocarditis / drug therapy
  • Myocarditis / etiology*
  • Stroke Volume
  • Tomography, X-Ray Computed

Substances

  • Immunosuppressive Agents
  • Cyclophosphamide