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

Introduction > Cardiac involvement is a rare manifestation of Wegener granulomatosis (WG). Because its prognosis con 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). Observation > This WG patient developed myocarditis with atrio-ventricular 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 on effective treatment in this patient.