A Case Report of Successful Immunosuppressive Therapy for Chronic Myocarditisстатья из журнала
Аннотация: In February 2013, a 61-year-old woman admitted to a hospital for dyspnea. She was diagnosed as having heart failure (HF) due to dilated cardiomyopathy and medical therapies were started. However, she had repeated episodes of acute exacerbation of HF and admission to the hospital. In December 2013, she was transferred to our hospital for the treatment of her refractory HF. On admission, she had symptoms of NYHA III and elevated BNP level (1188 pg/ml). Cardiac MRI showed reduced left ventricular ejection fraction (LVEF, 22%) and delayed enhancement in the apex. Right heart catheterization showed low cardiac index (CI, 2.03 L/min/m2), and endomyocardial biopsy revealed lymphocytic infiltration, indicating chronic myocarditis. Chest X-ray and chest computed tomography showed multiple consolidations on both lungs, and transbronchial lung biopsy showed the presence of organizing pneumonia. Although tuberculin skin test was negative, FDG-PET, laboratory tests and endomyocardial and lung biopsies showed no other findings suggestive of cardiac sarcoidosis. Despite optimal treatments for HF, LVEF was not improved. In February 2014, we started immunosuppressive therapy with prednisolone (40 mg/day) and azathioprine (50 mg/day) with resultant improvement of LVEF (LVEF 41%, CI 2.61 L/min/m2) in 2 weeks. Furthermore, endomyocardial biopsy after the immunosuppression therapy showed disappearance of lymphocytic infiltration in the myocardium. Thus, immunosuppressive therapy dramatically improved LV dysfunction in this case of chronic myocarditis.
Год издания: 2014
Авторы: Haruka Sato, Tatsuo Aoki, Koichiro Sugimura, Kotaro Nochioka, Shunsuke Tatebe, Saori Yamamoto, Masanobu Miura, Nobuhiro Yaoita, Kimio Satoh, Hiroaki Shimokawa
Издательство: Elsevier BV
Источник: Journal of Cardiac Failure
Ключевые слова: Viral Infections and Immunology Research, Sarcoidosis and Beryllium Toxicity Research, Orthopedic Infections and Treatments
Открытый доступ: hybrid
Том: 20
Выпуск: 10
Страницы: S206–S206