TY - JOUR T1 - Myocarditis in systemic lupus erythematosus diagnosed by <sup>18</sup>F-fluorodeoxyglucose positron emission tomography JF - Lupus Science &amp; Medicine DO - 10.1136/lupus-2018-000265 VL - 5 IS - 1 SP - e000265 AU - Alexandra Perel-Winkler AU - Sabahat Bokhari AU - Thania Perez-Recio AU - Afshin Zartoshti AU - Anca Askanase AU - Laura Geraldino-Pardilla Y1 - 2018/07/01 UR - http://lupus.bmj.com/content/5/1/e000265.abstract N2 - Objectives Cardiovascular diseaseand heart failure (CHF) are leading causes of death in systemic lupus erythematosus (SLE). The underlying mechanisms for increased CHF in SLE are unclear but myocardial inflammation and lupus myocarditis (LM) may play a role. We propose that 18F-fluorodeoxyglucose–positron emission tomography (18F-FDG–PET)/CT can help diagnose LM.Methods This report describes eight patients with presumed LM; five patients were evaluated due to active cardiorespiratory symptoms and three patients were participating in a pilot study to determine the prevalence of subclinical myocarditis in SLE. Clinical characteristics, laboratory and cardiac testing including electrocardiography (ECG), transthoracic echocardiogram (TTE), coronary artery evaluation as well as 18F-FDG–PET/CT imaging are discussed.Results Four patients were African American and the others were Hispanic. Half presented with chest pain; 37% had dyspnoea and 25% were asymptomatic. The median SLE Disease Activity Index (SLEDAI-2K) was 5 (2–18) and SLICC Damage Index (SDI) 0.5 (0–5). The median troponin level was 0.08 ng/mL (0–0.9). The most common ECG findings were non-specific ST-T wave abnormalities (n=5). Fifty per cent of the patients had a decreased ejection fraction on TTE and all patients had diffuse myocardial FDG uptake on 18F-FDG–PET/CT consistent with myocardial inflammation.Conclusion This case series is the first to describe the use of 18F-FDG–PET/CT in the diagnosis of LM and discuss the clinical characteristics and cardiac findings of eight patients with LM supporting the role for cardiac 18F-FDG–PET/CT in its diagnosis. ER -