Lash A D, Wittman A L, Quismorio F P
Semin Arthritis Rheum. 1986 May;15(4):288-96. doi: 10.1016/0049-0172(86)90024-7.
The clinical course and cardiac pathology of three adults with MCTD who developed myocarditis and that of two other previously reported cases are reviewed. The patients presented with cardiomegaly, congestive heart failure, ventricular arrhythmias, and elevated serum CPK MB fraction. Except for more frequent episodes of serositis and less prevalent neuropsychiatric manifestations and hepatosplenomegaly, no distinguishing features were found in MCTD patients with myocarditis compared with those without myocardial involvement. The concomitant onset of proximal myositis and myocarditis in one patient suggests a common inflammatory pathologic process in the skeletal and cardiac muscles. Circulating antibodies to myocardium and to cardiac conduction tissue were found in nine of 23 (39%) MCTD patients, but the presence of these autoantibodies was not associated with the occurrence of clinical cardiac involvement. The clinical and pathologic features of the five MCTD patients were similar to that of SLE patients with myocarditis. Primary myocardial involvement in MCTD, as in SLE, was associated with a relatively poor prognosis.
回顾了3例患有混合性结缔组织病（MCTD）并发生心肌炎的成人患者以及另外2例先前报道病例的临床病程和心脏病理学情况。这些患者表现为心脏扩大、充血性心力衰竭、室性心律失常以及血清肌酸磷酸激酶同工酶（CPK MB）分数升高。与无心肌受累的MCTD患者相比，患有心肌炎的MCTD患者除了浆膜炎发作更频繁、神经精神表现和肝脾肿大不太常见外，未发现其他显著特征。1例患者近端肌炎和心肌炎同时发作，提示骨骼肌和心肌存在共同的炎症病理过程。在23例（39%）MCTD患者中的9例发现了抗心肌和心脏传导组织的循环抗体，但这些自身抗体的存在与临床心脏受累的发生无关。这5例MCTD患者的临床和病理特征与患有心肌炎的系统性红斑狼疮（SLE）患者相似。与SLE一样，MCTD中的原发性心肌受累与相对较差的预后相关。
