Rituximab reversed cardiac involvement of Wegener's granulomatosis: magnetic resonance imaging assessment.

Presse Med

French Vasculitis Study Group, Department of internal medicine, AP-HP, Hôpital Cochin, Université Paris 5 Descartes, F-75679 Paris Cedex 14, France.

Published: March 2008

Introduction: Cardiac involvement is a rare manifestation of Wegener granulomatosis (WG). Because its prognosis can be poor, it must be diagnosed early to be treated adequately. We report the disease course of a patient who received rituximab to treat cardiac involvement documented by contrast-enhanced cardiac magnetic resonance imaging (ceCMR).

Case: This WG patient developed myocarditis with atrioventricular block. CeCMR proved useful in the diagnosis and follow-up of cardiac involvement. Several unsuccessful regimens preceded the prescription of rituximab. Two months later, regression of the myocarditis shown by ceCMR images was correlated with electrophysiological improvement.

Discussion: CeCMR assessment of a heart conduction defect in a patient with WG showed that this tool was useful for the diagnosis and follow-up of cardiac involvement in this vasculitis. Rituximab was an effective treatment in this patient.

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http://dx.doi.org/10.1016/j.lpm.2007.08.019DOI Listing

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