Fatal Myocarditis in a Male with Systemic Sclerosis

Cardiac involvements in systemic sclerosis have a poor outcome. We report here a case of 28 year-old-man with history of systemic sclerosis developing a fatal myocarditis. Initially patient has disabling joint manifestation. Systemic sclerosis is diagnosed after progressive development of cutaneous, pulmonary, and gastrointestinal manifestations. One year after systemic sclerosis diagnosis, our patient develops heart failure signs when he is already treated with methotrexate (15 mg/week) and coticosteroids (15 mg/day).

A 28 year-old-man without medical history was complaining of arthralgia, Raynaud’s phenomenon and dysphagia since two years. At presentation, patient had no dyspnea or chest pain. At examination he has a persistent fever and synovitis with joint finger deformities. Sclerotic skin face and sclerodactylia with digital ulcers are apparent. Capillaroscopy show severe organic microangiopathy and foggy aspect without megacapillaries. Thoracic computed tomography confirms interstitial lung disease without forced vital capacity alteration (80%). Gastro-esophageal endoscopy reveals esophagitis. Cardiac echography doesn’t show any abnormality. C-reactive protein is high and creatinin phosphokinase is normal. Antinuclear antibodies are positive (1/800) and anti-centromere are negative. Read more>>>>>>>>>>>>>>>>>