The multiple faces of autoimmune/immune‐mediated myocarditis in children: a biopsy‐proven case series treated with immunosuppressive therapy. (16th January 2021)

• Record Type: Journal Article
• Authors: Marcolongo, Renzo; Rizzo, Stefania; Cerutti, Alessia; Reffo, Elena; Castaldi, Biagio; Baritussio, Anna; Basso, Cristina; Di Salvo, Giovanni; Caforio, Alida L.P.
• Is Part Of: ESC heart failure. Volume 8:Number 2(2021)
• Page Start: 1604
• Page End: 1609
• Publication Date: 2021-01-16
• Subjects: Myocarditis -- Immunosuppressive therapy -- Children -- Endomyocardial biopsy; Heart failure -- Periodicals; 616.129005
• DOI: 10.1002/ehf2.13163
• Languages: English
• ISSNs: 2055-5822

Abstract

Abstract: The role of immunosuppressive therapy (IT) in paediatric autoimmune/immune‐mediated myocarditis remains poorly defined. To explore its role, we present a series of three consecutive paediatric patients with biopsy‐proven, virus negative, autoimmune/immune‐mediated myocarditis, with distinct clinical and pathological features, who have been successfully treated with IT, a 14‐year‐old boy with Loeffler's fibroblastic parietal endomyocarditis, a 6‐year‐old child with celiac disease with chronic active lymphocytic myocarditis, and a 13‐year‐old boy with long‐standing heart failure and active lymphocytic myocarditis. Patients started IT and entered follow‐up between July 2017 and September 2019; the first patient completed IT. IT was associated with a substantial and sustained recovery of cardiac function in our patients, regardless of their heterogeneous clinical and pathological features. Combination IT was well tolerated and enabled tapering and weaning off steroids.