Frustaci A, Gentiloni N, Caldarulo M
Department of Cardiology, Catholic University, Rome, Italy.
Chest. 1996 Jan;109(1):282-4. doi: 10.1378/chest.109.1.282.
A case of systemic lupus erythematosus (SLE) associated with fever, heart failure, and left ventricular (LV) aneurysm is reported. A diagnosis of SLE was suspected owing to the presence of active lymphocytic myocarditis and fibrinous endocarditis at LV endomyocardial biopsy and was confirmed by identification of 4 of the 11 criteria proposed by the American Rheumatism Association for the definition of SLE. A 2-month period of steroid therapy was followed by a remarkable recovery of LV function and progression of endomyocarditis to a healed phase at control LV biopsy. The LV aneurysm disappeared, likely because thrombosis occurred as a result of the hypercoagulable state accompanying the presence of anticardiolipin antibodies. This is the first reported case of LV aneurysm induced by SLE and is a rare clinicohistologic documentation of the effectiveness of steroid treatment on lupus endomyocarditis.
报告了1例系统性红斑狼疮（SLE）合并发热、心力衰竭及左心室（LV）动脉瘤的病例。左心室心内膜活检发现活动性淋巴细胞性心肌炎和纤维蛋白性心内膜炎，怀疑为SLE，经美国风湿病协会提出的11项SLE诊断标准中的4项确诊。经过2个月的类固醇治疗，左心室功能显著恢复，在对照左心室活检时心内膜炎进展至愈合期。左心室动脉瘤消失，可能是由于抗心磷脂抗体导致的高凝状态引发了血栓形成。这是首例由SLE诱发左心室动脉瘤的报告病例，也是类固醇治疗狼疮性心内膜炎有效性的罕见临床组织学记录。
