[Immunosuppressive treatment of chronic myocarditis].
6 children aged 9 months to 13 8/12 years developed reduced physical capacity, failure to thrive, dyspnoea on effort and heart failure after viral infection. Bed rest and anticongestive therapy did not reduce the severe heart failure. Immunosuppressive therapy with prednisolone 2 mg/kg/d and azathioprine 2 mg/kg/d was added on the assumption of chronic myocarditis (n = 4) or endocardial fibrosis (n = 2). 3 of the 6 children showed a considerable improvement in heart size, ECG and systolic heart function. Interruption of immunosuppressive therapy due to side effects in one child led to cardiac deterioration, which was reversed by renewed prednisolone therapy. Two patients died of progressive congestive heart failure. Heart transplantation was successfully performed in the now 14 year-old girl who was suffering from terminal dilated cardiomyopathy. Since there is no specific test for selecting patients who are likely to benefit from immunosuppressive therapy we feel this regimen would be justified in hopeless cases of congestive cardiomyopathy who have not responded to conventional therapy with anti-congestive drugs.
Wimmer
M
M
Universitäts-Kinderklinik, Wien.
Proll
E
E
Salzer-Muhar
U
U
Schlemmer
M
M
Strigl
E
E
D000293:Adolescent; D001327:Autoimmune Diseases / Q000188:drug therapy; D001379:Azathioprine / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000188:drug therapy; D006801:Humans; D007223:Infant; D008297:Male; D009205:Myocarditis / Q000188:drug therapy*; D011239:Prednisolone / Q000627:therapeutic use*
D011239:Prednisolone; D001379:Azathioprine
Immunsuppressive Behandlung der chronischen Myocarditis.