Acute papillary muscle infarction and rupture in the puerperium complicating Libman-Sacks endocarditis in a patient with systemic lupus erythematosus and antiphospholipid syndrome: a case report.

Background: Acute heart failure caused by severe mitral regurgitation (MR) due to papillary muscle rupture has been described in the puerperium by case reports; however, the majority of cases of papillary muscle rupture are caused by myocardial infarction. We describe papillary muscle rupture occurring in the postpartum period in a patient with systemic lupus erythematosus (SLE), antiphospholipid syndrome (APLS), and chronic Libman-Sacks endocarditis and explore the multifactorial nature of the papillary muscle infarction and rupture in the setting of postpartum fluid shifts, chronic myocardial injury from Libman-Sacks, and high thrombotic risk.

Case Summary: A 29-year-old woman presented with acute heart failure 2 weeks' postpartum and was found to have acute MR due to a flail leaflet caused by papillary muscle rupture.

Categorisation of foot complaints in systemic lupus erythematosus (SLE) from a New Zealand cohort.

Background: Foot complaints have been shown to be common in systemic lupus erythematosus (SLE) and heterogeneous in nature. We aimed to categorize self-reported foot complaints in people with SLE and foot symptoms.

Methods: A self-administered validated questionnaire was posted to 406 people with SLE attending adult rheumatology clinics across three health boards in Auckland, New Zealand.

Patterns of foot complaints in systemic lupus erythematosus: a cross sectional survey.

Background: Foot complaints are common in inflammatory arthropathies such as rheumatoid arthritis and cause considerable disability. However, little is published about the nature and extent of foot complaints in systemic lupus erythematosus (SLE). We aimed to explore foot complaints among people with (SLE) and to evaluate the associations between foot pain and self-reported activities of daily living and well-being.

Long-term follow-up of patients with idiopathic inflammatory myopathy at Waitemata District Health Board.

Background: Idiopathic inflammatory myopathies (IIMs) are an uncommon group of diseases that can be associated with significant morbidity and mortality related to systemic involvement or treatment-related complications.

Aim: This study reports the concomitant diseases, extent of organ involvement, immunosuppressive use, treatment-related complications and damage outcome in a cohort of adult IIM.

Methods: All patients with IIM fulfilling at least 3 of the 4 Bohan and Peter criteria were identified.

Screening for pulmonary arterial hypertension in patients with scleroderma--a New Zealand perspective.

Background: Pulmonary arterial hypertension (PAH) in scleroderma (SSc) patients is a devastating complication with high mortality if untreated. Early recognition and specific treatment of PAH may improve outcome. Regular interval screening for PAH is generally recommended in scleroderma patients especially with the availability of emerging new therapies.

Pericardial effusions with tamponade and visceral constriction in patients with rheumatoid arthritis on tumour necrosis factor (TNF)-inhibitor therapy.

Tumour necrosis factor-inhibitor (TNF-inhibitor) therapy is increasingly used for the treatment of rheumatoid arthritis. While it is effective for the articular manifestations of rheumatoid arthritis we have reason to believe that it is less effective for extra-articular disease. We present two cases of life-threatening cardiac tamponade in two patients with well-controlled rheumatoid arthritis on adalimumab.