Background/Purpose: To determine the factors associated with occurrence of acute myocarditis (AMC) and its outcomes in patients with systemic lupus erythematosus (SLE). 

Methods: This was a retrospective study of hospitalized SLE patients with AMC from 2002 to 2014 at Catholic University affiliated hospitals. A diagnosis of AMC was made on the basis of clinical findings, electrocardiographic changes, elevated cardiac enzymes levels and echocardiographic abnormalities. Eighty-six SLE patients who showed no echocardiographic evidence of myocarditis were enrolled as a control group. The clinical and laboratory data from each patient were collected from the charts and compared between 2 groups. 

Results: During these periods, 22 SLE patients were identified to have AMC (male 3, female 19). Patients with AMC, as compared with those without, were found to be associated with shorter disease duration and higher frequency of smoking (P<0.005, P<0.05, respectively). Moreover, they showed significantly higher SLE disease activity index score (P<0.001) and C-reactive protein levels (P<0.001), but lower complement levels (C3, C4 and CH50, all P<0.005). Interestingly, antiphospholipid syndrome (APS) was more prevalent in patients with AMC compared with those without (P<0.01). In multivariate analysis, shorter disease duration, smoking and presence of APS were independent factors associated with AMC in SLE patients. All patients with AMC received high-dose corticosteroid and 2 of them received intravenous cyclophosphamide; 17 patients completely recovered, but 5 died. 

Conclusion: AMC patients are more likely to have high disease activity and its occurrence is associated with shorter disease duration, smoking, and presence of APS.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/acute-myocarditis-in-patients-with-systemic-lupus-erythematosus-experience-from-affiliated-hospitals-of-catholic-university-of-korea/