Treatment of lupus myocarditis has not been assessed in controlled trials. Improvemen in systolic function has been noted in some patient treated with steroid,other immunosuppressant(cyclopho,azathioprine).

We suggest that acute lupus myocarditis be treated initially with pulse steroid 3 days then followed by 1mg /kg/day in divided dose pluse usual therapy for heart failure, if present.

Cardiomyopathy with fibrosis is usually resistant to steroid and/ or immunosuppressive drugs

Thanks. but 1mg/kg/day for how long,and is it necessary to taper and maintenance dose

Controlled studies are lacking and treatment is emperical but it depends on the severity of the lupus myocarditis. There are some experts who suggest that if the myocarditis is severe and life threating,3 days of pulse methylprednisolone should be followed by pulse cyclophosphamide for 3-6 months or MMF. Tapering doses of prednisone should be added to the above regimen. There have been reports of improvement with IV Ig as well as plasmapharesis.

Thanks

You're welcome.