Immunoadsorption therapy improved left ventricular ejection fraction from 22%-24% to 29.2% and reduced pro-BNP from 4454 pg/mL to 2109 pg/mL in a patient with advanced DCM.
Does immunoadsorption improve symptoms and cardiac function in a patient with advanced, treatment-refractory dilated cardiomyopathy?
Immunoadsorption followed by IVIG may offer clinical benefit in improving symptoms, biomarkers, and ejection fraction in patients with advanced, refractory dilated cardiomyopathy.
Absolute Event Rate: 0% vs 0%
Rationale: Dilated cardiomyopathy (DCM) is a major cause of chronic heart failure, and some patients continue to deteriorate despite guideline-directed medical therapy. Immunoadsorption (IA), which removes pathogenic autoantibodies, has been proposed as a potential adjunctive therapy, but its clinical use remains limited. This case illustrates the potential benefits of IA in advanced, treatment-refractory DCM. Patient concerns: A 53-year-old woman with a 9-year history of DCM presented with recurrent chest tightness and dyspnea. Despite long-term guideline-directed medical therapy, her symptoms progressively worsened. Diagnoses: The patient had chronic DCM initially diagnosed in the peripartum period, with a left ventricular ejection fraction (LVEF) of 11% at onset. Before IA, echocardiography demonstrated severe systolic dysfunction (LVEF 22%–24%) with significant mitral regurgitation, and laboratory evaluation showed markedly elevated pro-BNP (4454 pg/mL). Interventions: The patient underwent two sessions of immunoadsorption in September 2024, followed by high-dose intravenous immunoglobulin (IVIG) as per standard protocols. Outcomes: Following treatment, her symptoms improved, pro-BNP decreased to 2109 pg/mL, and repeat echocardiography showed an increase in LVEF to 29.2%. Lessons: This case suggests that immunoadsorption may offer clinical benefit in patients with advanced, refractory DCM. While promising, IA remains experimental and requires further investigation in larger, controlled studies.
Zhang et al. (Fri,) reported a other. Immunoadsorption therapy improved left ventricular ejection fraction from 22%-24% to 29.2% and reduced pro-BNP from 4454 pg/mL to 2109 pg/mL in a patient with advanced DCM.