Key result
High-dose steroids and cyclophosphamide improve LVEF to 48% in fulminant lupus myocarditis, but AV block persists.
Case Report (n=1)
High-dose immunosuppressive therapy can reverse severe myocardial dysfunction in fulminant lupus myocarditis, though conduction system abnormalities may persist.
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Rare SLE myocarditis can progress to shock and AV block; hypothesis-generating and should not yet change practice.
Fulminant myocarditis is an uncommon but severe cardiac manifestation of systemic lupus erythematosus (SLE), which can rapidly progress to heart failure and life-threatening rhythm disturbances. We report the case of a 33-year-old woman with a recent diagnosis of SLE who developed rapidly progressive cardiac involvement leading to cardiogenic shock and complete atrioventricular block. Her condition required intensive care management, including mechanical ventilation and temporary pacing. Following treatment with high-dose corticosteroids and cyclophosphamide, a marked improvement in ventricular function was observed, with the left ventricular ejection fraction increasing from 20% to 48%. Despite this recovery, the conduction abnormality persisted. This case highlights the fulminant presentation of lupus myocarditis, the reversibility of myocardial dysfunction and the potential persistence of conduction system involvement.
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Meryem et al. (2026) conducted a case report in Fulminant lupus myocarditis (n=1). High-dose corticosteroids and cyclophosphamide was evaluated on Ventricular function and conduction abnormality. Treatment with high-dose corticosteroids and cyclophosphamide improved left ventricular ejection fraction from 20% to 48% in a patient with fulminant lupus myocarditis, but AV block persisted.
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