Successful use of plasma exchange in fulminant lupus myocarditis coexisting with pneumonia: A case report

Figure 1 Computed tomography scan of the chest. A: Image showing increased pulmonary vascular diameter (orange horizontal arrow), ground-glass attenuation (orange oblique arrow), interlobar fissure effusion (orange vertical arrow) and consolidation in the right lower lobe of the lung (white vertical arrow); B: Image showing an enlarged heart (horizontal arrow) and consolidation in both lower lobes of the lung (vertical arrow).

Figure 2 Point-of-care ultrasound before undergoing therapy. A: Image showing an enlarged heart with a left ventricular end diastolic diameter of 50 mm (white line); B: Image showing a decreased left ventricular ejection fraction of 39.69%; C: Image showing a widened inferior vena cava with a diameter of 22 mm (orange vertical arrow); D: Image showing diffuse B lines in both lung fields (white horizontal arrow).

Figure 3 Clinical course and vasopressor doses. Moxifloxacin and meropenem were prescribed on days 1-10. Methylprednisolone was administered on days 1-12. IVIG was administered on days 1-5. PE was conducted twice on days 6 and 7, respectively. IVIG: Intravenous immunoglobulin; PE: Plasma exchange.

Figure 4 Point-of-care ultrasound after undergoing therapy. A: Image showing a normal left ventricular end diastolic diameter of 38 mm (white line); B: Image showing a normal left ventricular ejection fraction of 63.3%.