Combined immunosuppression for the treatment of idiopathic giant cell myocarditis.

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 Proc

journal_title

Mayo Clinic proceedings

authors

Menghini VV,Savcenko V,Olson LJ,Tazelaar HD,Dec GW,Kao A,Cooper LT Jr

doi

10.4065/74.12.1221

keywords:

subject

Has Abstract

pub_date

1999-12-01 00:00:00

pages

1221-6

issue

12

eissn

0025-6196

issn

1942-5546

pii

S0025-6196(11)64154-2

journal_volume

74

pub_type

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