Document Detail

Successful high-dose intravenous immunoglobulin therapy for a patient with fulminant myocarditis.
MedLine Citation:
PMID:  17285446     Owner:  NLM     Status:  MEDLINE    
A 45-year-old man developed fulminant myocarditis for which ventricular assist devices (intra-aortic balloon pumping and percutaneous cardiopulmonary support) were required for hemodynamic support. Echocardiography showed left ventricular akinesis and, since no improvement was noted on the following day, immunoglobulin (70 g/day for 2 days) was added to the therapy. The left ventricular ejection fraction increased to 25% and 40% at 12 and 36 h, respectively, representing a marked improvement in wall motion within a very short period. An endomyocardial biopsy specimen revealed focal lymphomononuclear infiltrate with adjacent myocytolysis, and acute lymphocytic myocarditis was diagnosed. Two days after administration of immunoglobulin, the serum level of interleukin-6 decreased rapidly from 180 to 5.9 pg/ml. In this patient, cardiac function improved immediately after immunoglobulin administration, suggesting the usefulness of this therapy. Three years after the diagnosis the patient is in good health, with steady normal left ventricular ejection fraction. We conclude that there are cases of acute myocarditis in which high-dose intravenous immunoglobulin therapy is effective.
Shigeru Kato; Shin-ichiro Morimoto; Shinya Hiramitsu; Akihisa Uemura; Masatsugu Ohtsuki; Yasuchika Kato; Kenji Miyagishima; Nami Mori; Hitoshi Hishida
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Publication Detail:
Type:  Case Reports; Journal Article     Date:  2007-01-26
Journal Detail:
Title:  Heart and vessels     Volume:  22     ISSN:  0910-8327     ISO Abbreviation:  Heart Vessels     Publication Date:  2007 Jan 
Date Detail:
Created Date:  2007-02-07     Completed Date:  2007-10-09     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8511258     Medline TA:  Heart Vessels     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  48-51     Citation Subset:  IM    
Division of Cardiology, Department of Internal Medicine, Fujita Health University School of Medicine, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake, Aichi, 470-1192, Japan.
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MeSH Terms
Endocardium / pathology
Heart-Assist Devices
Immunoglobulins, Intravenous / administration & dosage*
Middle Aged
Myocarditis / therapy*
Myocardium / pathology
Shock, Cardiogenic / therapy
Stroke Volume
Reg. No./Substance:
0/Immunoglobulins, Intravenous

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