Key result
Endomyocardial biopsy confirms immune checkpoint inhibitor myocarditis despite normal cardiac magnetic resonance imaging.
Why the study?
Immune checkpoint inhibitor-associated myocarditis has a low incidence but a high fatality rate, and diagnosis can be challenging when cardiac magnetic resonance imaging is normal.
Can endomyocardial biopsy diagnose ICI-related myocarditis in patients with a normal cardiac magnetic resonance imaging?
Case Report (n=1)
Can endomyocardial biopsy diagnose ICI-related myocarditis in patients with a normal cardiac magnetic resonance imaging?
Endomyocardial biopsy can diagnose ICI-related myocarditis even when cardiac MRI is normal, highlighting its potential value in suspected cases.
Answers are grounded in this paper and cite their sources.
EMB can identify ICI-myocarditis missed by cMRI; leaves open whether biopsy should supplement imaging in high-suspicion cases.
Immune checkpoint inhibitors (ICIs) have improved the management and the prognosis of patients with cancer but are associated with an increased risk of toxicities that can affect every organ. ICI-associated myocarditis has a low incidence (< 1%) but a high fatality rate (30%-50%). Herein we report a patient treated with ICI admitted for suspicion of myocarditis. Cardiac magnetic resonance imaging (cMRI) was normal. An endomyocardial biopsy (EMB) was in favour of ICI-related myocarditis with cardiac lymphohistiocytic infiltrate. This case highlights the role of a systematic evaluation with electrocardiography and troponin and the potential value of EMB in patients without a suggestive cMRI.
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Éderhy et al. (2020) conducted a case report in Immune checkpoint inhibitor-associated myocarditis (n=1). Endomyocardial biopsy (EMB) vs. Cardiac magnetic resonance imaging (cMRI) was evaluated on Diagnosis of ICI-related myocarditis. Endomyocardial biopsy successfully diagnosed immune checkpoint inhibitor-related myocarditis in a patient who had normal cardiac magnetic resonance imaging.
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