The combination of ECMO and immunosuppression including rATG may be a life-saving strategy for cardiogenic shock secondary to giant cell myocarditis.
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May support ECMO plus rATG immunosuppression in giant cell myocarditis shock; hypothesis-generating and requires prospective validation.
Giant cell myocarditis (GCM) is a rare and frequently fatal disorder. Patients suffer of ventricular arrhythmias or congestive heart failure. Here we describe a patient with cardiogenic shock and histological verified GCM. The patient was saved by implantation of extracorporeal membrane oxygeneation (ECMO) device and concomitant application of Rabbit antithymocyte globuline (rATG, Thymoglobulin, Sangstat), cyclosporine, and steroids in the acute event. 12 months after the crisis the patient evidences NYHA class I heart function and only a moderate impairment of heart function (EF 55%). The novel utilisation of ECMO in GCM related cardiogenic shock and application of rATG have prooven life-saving in this patient. Studies utilizing rATG in the treatment of GCM are warrented.
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Ankersmit et al. (2006) studied this question.
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