Document Detail

Acute myocarditis associated with adenoviral infection in a patient with scleroderma.
MedLine Citation:
PMID:  14677036     Owner:  NLM     Status:  MEDLINE    
We describe a 40-year-old man with limited scleroderma who presented with acute heart failure following a flu-like illness. He was known to have incomplete left anterior bundle branch block, initial isolated pulmonary hypertension with enlarged right atrium, and no pulmonary fibrosis. He received therapy for acute heart failure and was transferred to a scleroderma centre for specific treatment of scleroderma cardiomyopathy. Investigations showed raised inflammatory markers and diffuse hyperechogenic thickening of the myocardium on echocardiography. Contrast-enhanced (Gd-DOTA) cardiovascular magnetic resonance imaging (CV-MRI) showed multiple areas of non-homogeneous delayed hyperenhancement in the left ventricle, suggestive of myocarditis. Antiadenovirus IgM antibodies were detected with a titer consistent with recent infection. Six weeks later a repeat Gd-DOTA CV-MRI showed an almost complete resolution of the areas of hyperenhancement and there was a significant reduction in the adenovirus antibody titer with serological conversion to IgG. To our knowledge this is the first report of viral myocarditis in scleroderma. Infections are important causes of morbidity and mortality in this disease and should always be included in the differential diagnosis of cardiac symptoms. We propose that contrast-enhanced CV-MRI is valuable in a non-invasive diagnosis of heart disease in patients with scleroderma.
Magdalena Dziadzio; Andrea Giovagnoni; Giovanni Pomponio; Andrea Recanatini; Osmy Paci della Costanza; Aldo Manzin; Walter Casagrande; Armando Gabrielli
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Publication Detail:
Type:  Case Reports; Journal Article     Date:  2003-11-08
Journal Detail:
Title:  Clinical rheumatology     Volume:  22     ISSN:  0770-3198     ISO Abbreviation:  Clin. Rheumatol.     Publication Date:  2003 Dec 
Date Detail:
Created Date:  2003-12-16     Completed Date:  2004-05-06     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8211469     Medline TA:  Clin Rheumatol     Country:  Belgium    
Other Details:
Languages:  eng     Pagination:  487-90     Citation Subset:  IM    
Istituto di Clinica Medica, Ematologia ed Immunologia Clinica, Università di Ancona, Ancona, Italy.
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MeSH Terms
Acute Disease
Adenoviridae / isolation & purification*
Adenoviridae Infections / complications,  diagnosis*,  drug therapy
Contrast Media
Drug Therapy, Combination
Follow-Up Studies
Magnetic Resonance Imaging / methods
Myocarditis / complications,  diagnosis*
Risk Assessment
Scleroderma, Systemic / complications,  diagnosis*,  drug therapy
Severity of Illness Index
Reg. No./Substance:
0/Contrast Media

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