Abstract
Introduction: systemic lupus erythematosus (sLE) is an autoimmune disorder involving multiple organs, predominantly seen in women of child-bearing age. Erythroderma is described in patients with subacute cutaneous lupus erythematosus (scLE) but is rare in sLE. Among the cardiac manifestations, pericarditis is common but myocarditis is rare. We report a case of severe sLE presenting with erythroderma, pancytopenia, arthralgia and myocarditis. case report: A 67-year-old male with a background history of hypertension, transient ischemic attack and polymyalgia rheumatica presented with severe erythroderma, malaise, arthralgia, weight loss and was found to be pancytopenic. His antinuclear antibody (ANA) was positive and double stranded DNA (dsDNA) was more than 200 IU/mL with very low complement levels. He developed lupus associated myocarditis with moderately impaired global left ventricular systolic function. He was initially started on steroids and hydroxychloroquine. but as he
Highlights
Systemic lupus erythematosus (SLE) is an autoimmune disorder involving multiple organs, predominantly seen in women of child-bearing age
We report a case of severe SLE presenting with erythroderma, pancytopenia, arthralgia and myocarditis
Received: 31 July 2014 Accepted: 16 August 2014 Published: 01 November 2014 developed steroid induced myopathy, it was gradually tapered off and mycophenolate mofetil was started. He responded well to the treatment. He satisfied 8 of the 17 systemic lupus international collaborating clinics (SLICC) criteria establishing a diagnosis of systemic lupus erythematosus (SLE)
Summary
Systemic lupus erythematosus (SLE) is an autoimmune disease involving multiple organs. White blood cell and platelets gradually normalized. Routine examination during his stay in the hospital revealed third heart sound with no signs of heart failure. He developed pain and weakness of the proximal muscles of both legs within seven days of starting steroids, so his steroid dose was reduced to 40 mg/day and gradually tapered and was started on mycophenolate mofetil (500 mg BD) His creatinine kinase (CK) was normal at 24 IU/L. The dose of mycophenolate mofetil was increased to 500 mg TDS after two weeks His exercise tolerance significantly improved, some mild residual erythema was present on the back at second month of follow-up but cleared at sixth month.
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