Lupus myocarditis, a reversible cause of heart failure in sub- Saharan Africa: a case report

Abstract

Systemic Lupus Erythematosus (SLE) is a chronic autoimmune disease with multisystemic involvement and varied clinical courses. It has a predilection for women in their reproductive ages. It is more common in sub-Saharan Africa than was previously reported. While pericarditis is a relatively common cardiac manifestation of lupus, myocarditis is a rare but potentially life-threatening manifestation. Myocarditis may present as heart failure amid other multisystemic manifestations. Therefore, a high index of suspicion is required for early diagnosis and prompt management to prevent fatal complications. We hereby present a 24 year old female who presented at our rheumatology clinic with generalized lymphadenopathy and inflammatory polyarthritis. She subsequently defaulted clinic follow-up until she presented five months later at the emergency department with sepsis, serositis, lupus myocarditis, and acute heart failure with reduced left ventricular ejection fraction. She was commenced on intravenous antibiotics and within days of methylprednisolone therapy, she experienced a dramatic improvement in her cardiac symptoms.