Key result
Thymoma-associated fulminant myocarditis carries rapid, fatal collapse despite aggressive immunotherapy and supportive care.
Why the study?
Fulminant myocarditis associated with invasive thymoma is a severe condition leading to sudden death, with limited data on clinical presentation and management.
Case Report (n=3)
No
Highlights the highly fatal nature of fulminant myocarditis in patients with invasive thymoma and myasthenia gravis, underscoring the urgent need for early mechanical circulatory support such as ECMO.
Highlights lethal progression of thymoma-associated fulminant myocarditis despite therapy; hypothesis-generating for improved recognition and interventions in this rare entity.
Fulminant myocarditis (FM) is a severe, rapidly progressive and life-threatening condition of myocarditis associated with infectious or autoimmune etiologies. Here, we present three patients with an invasive thymoma who had FM, which eventually led to sudden death. The most frequent clinical presentations at onset include palpitations, orthopnea, and acute worsening of myasthenia gravis (MG). Highly elevated myocardial biomarkers and positive autoantibodies against cardiac muscle, skeletal muscle, and neuromuscular junctions were detected in serum. The electrocardiograph (ECG) findings progressed to life-threatening ventricular arrhythmias. Although high-dose methylprednisolone or intravenous immunoglobulin was administered along with advanced respiratory support, profound hemodynamic collapse rapidly occurred, and these patients eventually died within days. This case series underscores the importance of rapid recognition of FM associated with thymoma and early aggressive supportive and immunomodulatory interventions, including consideration of mechanical circulatory support when clinically indicated.
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Liu et al. (2026) conducted a case report in Fulminant myocarditis associated with invasive thymoma (n=3). Invasive thymoma-associated autoimmunity was evaluated on Mortality. Three patients with invasive thymoma and fulminant myocarditis rapidly developed profound hemodynamic collapse and died within 4 to 5 days despite aggressive supportive and immunomodulatory therapies.
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