Abstract
Systemic lupus erythematosus has myriad presentations. Symptomatic myocarditis and/or symptomatic autoimmune hepatitis associated with lupus are rare at presentation. Here we report a young Asian girl, who presented to us with features of symptomatic myocarditis and overlapping autoimmune hepatitis. She was eventually diagnosed to be harboring systemic lupus erythematosus, in whom rigorous management led to gratuitous recovery.
Highlights
Systemic lupus erythematosus (SLE) can involve the heart in innumerable ways, namely, pericarditis, myocarditis, cardiomyopathy, and heart failure monopolizing almost every anatomic component of the heart
Endomyocardial biopsy remains the gold standard for diagnosis, but it has its pitfalls—an invasive process with associated complications—and there is a low sensitivity and specificity associated with it [3,4,5]
For urgent treatment-related decision making, clinical diagnosis of SLE myocarditis remains an important tool as untreated cases may develop abrupt and life-threatening complications including arrhythmias, dilated cardiomyopathy, and heart failure [4, 6]
Summary
Systemic lupus erythematosus (SLE) can involve the heart in innumerable ways, namely, pericarditis, myocarditis, cardiomyopathy, and heart failure monopolizing almost every anatomic component of the heart. Manifested myocarditis is rare in SLE and is excluded from the diagnostic criteria and disease activity index tool. Symptomatic hepatic involvement in SLE is well documented but considered a rarity. Patients of connective tissue disorders are susceptible for developing autoimmune hepatitis (AIH) and vice versa. Symptomatic myocarditis and autoimmune hepatitis in patients of SLE occurring simultaneously at presentation have not been reported before
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