A 32-Year-Old Woman With Arthralgias And Severe Hypotension

A 32-year-old woman with a history of undifferentiated connective tissue disease and symptoms of systemic lupus erythematosus (SLE) was diagnosed with giant cell myocarditis (GCM), a rare and aggressive form of myocarditis. Despite the severe prognosis typically associated with GCM, she responded well to an aggressive immunosuppressive treatment regimen, including glucocorticoids, cyclosporine, muromonab-CD3 (OKT3), and later mycophenolate mofetil (MMF). Her condition improved significantly over 15 weeks, with biopsies showing normal endomyocardium and no further necrosis or giant cells. At 1-year follow-up, she remained well on MMF and cyclosporine with minimal symptoms, highlighting the potential link between GCM and autoimmune diseases and suggesting that early and aggressive treatment may improve outcomes.