Key Points
- To report the management and clinical recovery of severe lupus myopericarditis complicated by cardiogenic shock using mycophenolate mofetil and corticosteroids.
- Evaluated a 33-year-old female presenting with acute heart failure, cardiogenic shock, cutaneous vasculitis, and acute renal impairment.
- Diagnosed lupus myopericarditis using cardiac magnetic resonance imaging, laboratory immunology testing (positive direct Coombs, anti-nuclear, and anti-native DNA antibodies), and echocardiography.
- Initiated guideline-directed heart failure medical therapy combined with high-dose corticosteroids and mycophenolate mofetil.
- Initial echocardiography demonstrated dilated cardiomyopathy with global hypokinesis, right ventricular dysfunction, and an ejection fraction of 20% to 25%.
- Treatment with mycophenolate mofetil and corticosteroids yielded marked clinical recovery and improved left ventricular ejection fraction to 45% to 50% by day 15.
Structured PICO
PPopulationn=1, 33-year-old woman with no past medical history presenting with systemic lupus complicated by cardiogenic shock secondary to troponin-negative acute myopericarditis.
IInterventionMycophenolate mofetil and corticosteroid therapy, in addition to heart failure medications.
OOutcomeImprovement in left ventricular ejection fraction and clinical signs of heart failure at day 15.
Mycophenolate mofetil combined with corticosteroids successfully treated a case of severe lupus myopericarditis complicated by cardiogenic shock, suggesting it as a promising therapy for this condition.