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Abstract
An 18-year-old woman with no prior medical history was admitted for acute heart failure in a febrile setting. Transthoracic echocardiography revealed severe aortic regurgitation with structurally normal valves, associated with hypokinetic dilated cardiomyopathy and a left ventricular ejection fraction of 39%. Three weeks later, the patient developed malar rash, mucosal ulcerations, distal ischemic skin lesions, and multiple thrombotic events, including pulmonary embolism and venous and arterial thromboses. Laboratory findings showed severe thrombocytopenia, autoimmune hemolytic anemia, and positive autoantibodies. A diagnosis of lupus myocarditis complicated by catastrophic antiphospholipid syndrome was established. Despite immunosuppressive therapy, the clinical course rapidly deteriorated, resulting in fatal multiorgan failure.
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References
- 1) Doherty NE, Siegel RJ. Cardiovascular manifestations of systemic lupus erythematosus. Am Heart J. 1985;110(6):1257–1265.
- 2) Tan EM, Cohen AS, Fries JF, et al. The 1982 revised criteria for the classification of systemic lupus erythematosus. Arthritis Rheum. 1982;25:1271–1277.
- 3) Doria A, Iaccarino L, Sarzi-Puttini P, et al. Cardiac involvement in systemic lupus erythematosus. Lupus. 2005;14(9):683–686.
- 4) Cervera R, Serrano R, Pons-Estel GJ, et al. Morbidity and mortality in the antiphospholipid syndrome during a 10-year period. Ann Rheum Dis. 2015;74(6):1011–1018.
- 5) De los Ríos A, Vázquez JJ, Sobrino JA, et al. Myocardial involvement in systemic lupus erythematosus: a noninvasive study of left ventricular function. Chest. 1978;74(4):414–417.
- 6) Pina FP, Silva GJ, Martins RP, et al. Early cardiac involvement in systemic lupus erythematosus. Rev Cienc Med. 2003;12:381–385.
- 7) Cervera R, Bucciarelli S, Plasin MA, et al. Catastrophic antiphospholipid syndrome (CAPS): descriptive analysis of 280 patients from the CAPS Registry. J Autoimmun. 2009;32:240–24
References
1) Doherty NE, Siegel RJ. Cardiovascular manifestations of systemic lupus erythematosus. Am Heart J. 1985;110(6):1257–1265.
2) Tan EM, Cohen AS, Fries JF, et al. The 1982 revised criteria for the classification of systemic lupus erythematosus. Arthritis Rheum. 1982;25:1271–1277.
3) Doria A, Iaccarino L, Sarzi-Puttini P, et al. Cardiac involvement in systemic lupus erythematosus. Lupus. 2005;14(9):683–686.
4) Cervera R, Serrano R, Pons-Estel GJ, et al. Morbidity and mortality in the antiphospholipid syndrome during a 10-year period. Ann Rheum Dis. 2015;74(6):1011–1018.
5) De los Ríos A, Vázquez JJ, Sobrino JA, et al. Myocardial involvement in systemic lupus erythematosus: a noninvasive study of left ventricular function. Chest. 1978;74(4):414–417.
6) Pina FP, Silva GJ, Martins RP, et al. Early cardiac involvement in systemic lupus erythematosus. Rev Cienc Med. 2003;12:381–385.
7) Cervera R, Bucciarelli S, Plasin MA, et al. Catastrophic antiphospholipid syndrome (CAPS): descriptive analysis of 280 patients from the CAPS Registry. J Autoimmun. 2009;32:240–24