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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 …