title: Complete AV-block in two children with immunohistochemical proven myocarditis.
abstract: We report two children with acquired third degree AV-block caused by acute myocarditis. The diagnosis was proven by endomyocardial biopsy. Severe lymphocytic myocardial infiltration was shown using immunohistological methods. One of the children was treated with prednisone During therapy conduction disturbance nearly disappeared and infiltration was markedly reduced in a subsequent biopsy. In the other patient the parents refused immunosuppressive treatment and a permanent pacemaker was necessary for persistent bradycardia.
  
  
  CONCLUSIONS
  Immunohistological staining of an endomyocardial biopsy can be used to establish the diagnosis of myocarditis in patients with atypical clinical manifestation, such as complete AV-block, and can support the decision for therapy. In one patient improvement was documented by the disappearance of inflammatory activity in a repeated biopsy.
authors.affiliation: Department of Paediatric Cardiology, Heinrich-Heine-University, Düsseldorf, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Heusch
authors.forename: U
authors.initials: U
authors.lastname: Kühl
authors.forename: S
authors.initials: S
authors.lastname: Rammos
authors.forename: O N
authors.initials: ON
authors.lastname: Krogmann
authors.forename: H P
authors.initials: HP
authors.lastname: Schultheiss
authors.forename: M
authors.initials: M
authors.lastname: Bourgeois
mesh_terms: D000208:Acute Disease; D002648:Child; D002675:Child, Preschool; D004562:Electrocardiography; D005260:Female; D006327:Heart Block / Q000175:diagnosis / Q000209:etiology*; D006801:Humans; D009205:Myocarditis / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D010138:Pacemaker, Artificial; D011241:Prednisone / Q000627:therapeutic use
chemical_list: D011241:Prednisone