ACUTE MYOCARDITIS AND LEFT-VENTRICULAR ANEURYSM AS PRESENTATIONS OF SYSTEMIC LUPUS-ERYTHEMATOSUS

A case of systemic lupus erythematosus (SLE) associated with fever, he art failure, and left ventricular (LV) aneurysm is reported. A diagnos is of SLE was suspected owing to the presence of active lymphocytic my ocarditis and fibrinous endocarditis at LV endomyocardial biopsy and w as 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 contr ol LV biopsy, The LV aneurysm disappeared, likely because thrombosis o ccurred as a result of the hypercoagulable state accompanying the pres ence of anticardiolipin antibodies, This is the first reported case of LV aneurysm induced by SLE and is a rare clinicohistologic documentat ion of the effectiveness of steroid treatment on lupus endomyocarditis .