{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,4]],"date-time":"2026-07-04T18:58:34Z","timestamp":1783191514385,"version":"3.54.6"},"reference-count":9,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2019,11,20]],"date-time":"2019-11-20T00:00:00Z","timestamp":1574208000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2019,11,20]],"date-time":"2019-11-20T00:00:00Z","timestamp":1574208000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Med Case Reports"],"published-print":{"date-parts":[[2019,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n<jats:title>Background<\/jats:title>\n<jats:p>Myocarditis is an uncommon manifestation of systemic lupus erythematosus in which the clinical presentation can range from subclinical to life-threatening. We report cases of two patients who presented to our hospital with myocarditis as an initial manifestation of systemic lupus erythematosus despite negative results of extensive workup that excluded other diagnoses. The mainstays of treatment are corticosteroids, immunosuppressive agents, and anti-heart failure medications, with use of the latter being case-specific. Mycophenolate mofetil was the cornerstone of the proposed treatment for induction of remission, although it is well known to be used as a maintenance therapy in lupus myocarditis.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Case presentation<\/jats:title>\n<jats:p>Both Emirati patients described satisfied the diagnostic criteria for mixed connective tissue disease (systemic lupus predominant) and systemic lupus erythematous. Other differential diagnoses of myocarditis were excluded. The patients were started on pulsed steroid followed by oral steroid, with hydroxychloroquine, mycophenolate mofetil, and anti-heart failure medications used as needed. Dramatic responses were noted in the first few weeks in terms of symptoms.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Conclusion<\/jats:title>\n<jats:p>Early recognition and treatment of lupus myocarditis is needed to avoid fatal consequences.<\/jats:p>\n<\/jats:sec>","DOI":"10.1186\/s13256-019-2242-1","type":"journal-article","created":{"date-parts":[[2019,11,20]],"date-time":"2019-11-20T01:01:49Z","timestamp":1574211709000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Myocarditis as a lupus challenge: two case reports"],"prefix":"10.1186","volume":"13","author":[{"given":"Shamma Ahmad","family":"Al-Nokhatha","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiba Ibrahim","family":"Khogali","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maryam Abdulla","family":"Al Shehhi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Imad Tarik","family":"Jassim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2019,11,20]]},"reference":[{"issue":"1","key":"2242_CR1","doi-asserted-by":"publisher","first-page":"24","DOI":"10.3899\/jrheum.160493","volume":"44","author":"G Thomas","year":"2016","unstructured":"Thomas G, Cohen Aubart F, Chiche L, Haroche J, Hi\u00e9 M, Hervier B, et al. Lupus myocarditis: initial presentation and longterm outcomes in a multicentric series of 29 patients. J Rheumatol. 2016;44(1):24\u201332.","journal-title":"J Rheumatol"},{"key":"2242_CR2","doi-asserted-by":"publisher","first-page":"679","DOI":"10.4172\/2165-7920.1000679","volume":"6","author":"Y Shinkawa","year":"2016","unstructured":"Shinkawa Y, Yagita M, Fujita M. Myocarditis in mixed connective tissue disease: a case report. J Clin Case Rep. 2016;6:679.","journal-title":"J Clin Case Rep"},{"issue":"13","key":"2242_CR3","doi-asserted-by":"publisher","first-page":"1378","DOI":"10.1177\/0961203312456752","volume":"21","author":"G Zawadowski","year":"2012","unstructured":"Zawadowski G, Klarich K, Moder K, Edwards W, Cooper L. A contemporary case series of lupus myocarditis. 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Lupus. 2011;20(9):981\u20138.","journal-title":"Lupus."},{"issue":"1","key":"2242_CR8","doi-asserted-by":"publisher","first-page":"e000265","DOI":"10.1136\/lupus-2018-000265","volume":"5","author":"A Perel-Winkler","year":"2018","unstructured":"Perel-Winkler A, Bokhari S, Perez-Recio T, Zartoshti A, Askanase A, Geraldino-Pardilla L. Myocarditis in systemic lupus erythematosus diagnosed by 18F-fluorodeoxyglucose positron emission tomography. Lupus Sci Med. 2018;5(1):e000265.","journal-title":"Lupus Sci Med"},{"issue":"1","key":"2242_CR9","doi-asserted-by":"publisher","first-page":"14","DOI":"10.1093\/rheumatology\/kex291","volume":"57","author":"C Gordon","year":"2017","unstructured":"Gordon C, Amissah-Arthur M, Gayed M, Brown S, Bruce I, D\u2019Cruz D, et al. The British Society for Rheumatology guideline for the management of systemic lupus erythematosus in adults: executive summary. Rheumatology. 2017;57(1):14\u20138.","journal-title":"Rheumatology."}],"container-title":["Journal of Medical Case Reports"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/s13256-019-2242-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1186\/s13256-019-2242-1\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/s13256-019-2242-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,11,19]],"date-time":"2020-11-19T00:24:37Z","timestamp":1605745477000},"score":1,"resource":{"primary":{"URL":"https:\/\/jmedicalcasereports.biomedcentral.com\/articles\/10.1186\/s13256-019-2242-1"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,11,20]]},"references-count":9,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2019,12]]}},"alternative-id":["2242"],"URL":"https:\/\/doi.org\/10.1186\/s13256-019-2242-1","relation":{},"ISSN":["1752-1947"],"issn-type":[{"value":"1752-1947","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,11,20]]},"assertion":[{"value":"25 March 2019","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"26 August 2019","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"20 November 2019","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"Ethical approval was not applicable for the case report.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Written informed consent was obtained from the patients for publication of this case report and any accompanying images. A copy of the written consent is available for review by the Editor-in-Chief of this journal.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"343"}}