Myocarditis occurs in 8–78% of necropsy studies of patients with systemic lupus erythematosus (SLE)^1,2 but is rare in clinical practice. We describe three patients with severe lupus myocarditis, who improved dramatically after intravenous immunoglobulin (IVIg) therapy.

Table 1 gives details of the cases studied.

A 37-year-old woman (patient 3) was diagnosed with lupus, confirmed by strongly positive anti-DNA, low complement, and positive anti-RNP and anti-Sm antibodies. She developed breathlessness and a restrictive lung function pattern and received mycophenolate. She was admitted with a respiratory tract infection, neutropenia (1.6×10 …