Key result
Combination immunosuppressive therapy with steroids, tacrolimus, and intravenous immunoglobulin improved left ventricular ejection fraction from 13% to 42% and allowed weaning from mechanical support.
Why the study?
Does combination immunosuppressive therapy with steroids, tacrolimus, and intravenous immunoglobulin improve cardiac function and survival in a patient with giant cell myocarditis?
Case Report (n=1)
No
Does combination immunosuppressive therapy with steroids, tacrolimus, and intravenous immunoglobulin improve cardiac function and survival in a patient with giant cell myocarditis?
Combination immunosuppressive therapy with steroids, tacrolimus, and intravenous immunoglobulin may be an effective treatment for giant cell myocarditis, leading to significant recovery of cardiac function and withdrawal from mechanical support.
A 60-year-old woman with a history of hypothyroidism was referred to our hospital for shortness of breath and a left ventricular ejection fraction (LVEF) of 13%, which required continuous dobutamine injection with intra-aortic balloon pump support. An endomyocardial biopsy obtained from the right ventricle revealed an infiltration of giant cells and eosinophils, indicating giant cell myocarditis. In addition to heart failure treatment, combined immunotherapy with steroids, tacrolimus, and intravenous immunoglobulin was administered. Transthoracic echocardiography demonstrated a dramatic improvement in the LVEF after this therapy, and the patient was discharged home without symptoms on day 72.
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Funaki et al. (2022) conducted a case report in Giant cell myocarditis (n=1). Combination immunosuppressive therapy (steroids, tacrolimus, and IVIG) was evaluated on Clinical and echocardiographic improvement. Combination immunosuppressive therapy with steroids, tacrolimus, and intravenous immunoglobulin improved left ventricular ejection fraction from 13% to 42% and allowed weaning from mechanical support.
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