Abstract:
:Giant cell myocarditis (GCM) is a rare and frequently fatal disorder with no proven treatment. Case reports and data from a rat model of GCM suggest that immunosuppressive therapy directed against T lymphocytes may have clinical benefit. We describe a 47-year-old man with severe acute heart failure due to GCM in whom the left ventricular ejection fraction normalized and the myocardial inflammatory infiltrate resolved rapidly after treatment with muromonab-CD3, cyclosporine, azathioprine, and corticosteroids. Three previously published cases with less impressive responses to treatment including muromonab-CD3 and a critical review of the published data on immunosuppressive therapy are included in this report. The response to immunosuppressive therapy is highly variable, and direct comparisons between immunosuppressive regimens do not exist. Therefore, despite individual reports of dramatic improvement after immunosuppressive treatment, firm conclusions cannot be made about the benefit of immunosuppression for GCM. The benefits of immunosuppressive therapy must be confirmed in a prospective, randomized trial.
journal_name
Mayo Clin Procjournal_title
Mayo Clinic proceedingsauthors
Menghini VV,Savcenko V,Olson LJ,Tazelaar HD,Dec GW,Kao A,Cooper LT Jrdoi
10.4065/74.12.1221keywords:
subject
Has Abstractpub_date
1999-12-01 00:00:00pages
1221-6issue
12eissn
0025-6196issn
1942-5546pii
S0025-6196(11)64154-2journal_volume
74pub_type
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journal_title:Mayo Clinic proceedings
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journal_title:Mayo Clinic proceedings
pub_type: 杂志文章,评审
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pub_type: 杂志文章,评审
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journal_title:Mayo Clinic proceedings
pub_type: 临床试验,杂志文章,随机对照试验
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