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Myocarditis in connective tissue diseases: an often-overlooked clinical manifestation

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Abstract

To discuss what is currently known about myocarditis in the context of major connective tissue diseases, including Systemic lupus erythematosus, Rheumatoid Arthritis, Sjogren, Dermato-myositis and Polymyositis, Systemic Sclerosis, and Mixed connective tissue disease. Variability exists between studies regarding the incidence of myocarditis in connective tissue diseases, which is hypothesized to be the result of its subclinical course in most cases. Extensive gaps of knowledge exist in the field of pathophysiology. Although endomyocardial biopsy remains to be the gold standard for diagnosis, the advancement in non-invasive modalities such as cardiac MRI, echocardiography, and nuclear medicine has allowed for earlier and more frequent detection of myocarditis. A lack of treatment guidelines was found across the different connective tissue diseases. Most of the literature available revolved around myocarditis in the context of Systemic lupus erythematosus. Numerous recent studies were published that contributed to advancements in diagnosis and treatment however, there remains a lack of diagnostic and treatment guidelines.

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  1. Muayad Azzam and Amro Awad contributed equally to this work.

Authors and Affiliations

  1. Faculty of Medicine, The University of Jordan, Amman, 11942, Jordan

    Muayad Azzam & Amro Awad

  2. Division of Rheumatology and Immunology, University of Toledo Medical Center, Toledo, USA

    Aya Abugharbyeh & Bashar Kahaleh

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  1. Muayad Azzam
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  2. Amro Awad
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  3. Aya Abugharbyeh
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  4. Bashar Kahaleh
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MA, AA, AG, BK have contributed to the conceptualization and design of the work. MA, AA, AG, BK have participated in drafting and revising of the intellectual content. All authors have read and agreed to the final version of the manuscript. All authors agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

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Correspondence to Muayad Azzam.

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Azzam, M., Awad, A., Abugharbyeh, A. et al. Myocarditis in connective tissue diseases: an often-overlooked clinical manifestation. Rheumatol Int 43, 1983–1992 (2023). https://doi.org/10.1007/s00296-023-05428-w

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