Giant cell myocarditis in an 18-year-old patient with new-onset systemic lupus erythematosus: A fatal case of rapidly progressing heart failure.
Lisa C Harling, Max Wacker, Arjang Ruhparwar et al.
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Case in brief
An 18-year-old patient presented with biventricular heart failure and newly diagnosed systemic lupus erythematosus (SLE). After a 6-month history of fatigue and malaise, echocardiography revealed a severely reduced left ventricular ejection fraction of 5%. Endomyocardial biopsy confirmed giant cell myocarditis (GCM). Despite aggressive treatment, including ECMO and immunosuppressive therapy, the patient succumbed to multiorgan failure before transplantation could be performed.
Diagnostic / clinical pearl
Differentiating giant cell myocarditis from lupus myocarditis is crucial due to their differing prognoses and treatment approaches, especially in young patients with rapid cardiac decline.
Why it matters
This case highlights the need for early biopsy in patients with autoimmune conditions presenting with cardiac symptoms to ensure timely and appropriate management.