Key result
Treatment with high doses of adrenocorticosteroids was rapidly successful in controlling the acute phase of myocarditis in three children with juvenile rheumatoid arthritis.
Case Report (n=3)
High-dose adrenocorticosteroids can rapidly control acute myocarditis in children with juvenile rheumatoid arthritis, but digoxin should be used cautiously due to toxicity risks.
May support steroids in rare JRA myocarditis; leaves open need for controlled trials before adoption.
Three children are described who have had myocarditis as part of juvenile rheumatoid arthritis (JRA). The diagnosis was established by the appearance of cardiomegaly or congestive heart failure or both in the absence of substantial pericardial effusion or extra cardiac cause. Myocarditis, in these cases, occurred on a background of severe, active systemic disease. No pathologic specimens from hearts of acute cases are available, but an autopsy specimen of one child who died after two months of treatment with high doses of steroids showed diffuse changes typical of the "dilated ventricle" type of cardiomyopathy. Treatment with high doses of adrenocorticosteroids has been rapidly successful in controlling the acute phase, while digoxin must be used with extreme care because of high incidence of toxicity to glycosides.
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John J. Miller (1977) conducted a case report in Myocarditis in juvenile rheumatoid arthritis (n=3). High doses of adrenocorticosteroids was evaluated on Control of the acute phase of myocarditis. Treatment with high doses of adrenocorticosteroids was rapidly successful in controlling the acute phase of myocarditis in three children with juvenile rheumatoid arthritis.
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