title: An autopsy case of giant cell myocarditis probably due to a non-steroidal anti-inflammatory drug.
abstract: An autopsy case of giant cell myocarditis (GCM) in a 74-year-old woman is presented. She suffered from hepatic dysfunction, skin eruption and disseminated intravascular coagulation due to the side-effects of a non-steroidal anti-inflammatory drug. After admission, heart failure progressed rapidly, and the patient died suddenly. At autopsy, her heart was slightly enlarged and the heart muscle was thickened with many small whitish nodules. She was diagnosed with GCM because of the infiltration of multinuclear giant cells, histiocytes, eosinophils and lymphocytes into the heart. We did not find any similar lesions in any other organs. Giant cell myocarditis, the etiology of which is not defined, is a rare disease with unfavorable prognosis. This case suggests the possibility of drug-induced GCM.
authors.affiliation: First Department of Pathology, Kansai Medical University, Osaka, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Adachi
authors.forename: R
authors.initials: R
authors.lastname: Yasumizu
authors.forename: F
authors.initials: F
authors.lastname: Hashimoto
authors.forename: Y
authors.initials: Y
authors.lastname: Otsuka
authors.forename: A
authors.initials: A
authors.lastname: Okamura
authors.forename: Y
authors.initials: Y
authors.lastname: Kato
authors.forename: H
authors.initials: H
authors.lastname: Oyaizu
authors.forename: K
authors.initials: K
authors.lastname: Ikebukuro
authors.forename: S
authors.initials: S
authors.lastname: Fukuhara
authors.forename: Y
authors.initials: Y
authors.lastname: Nakai
authors.forename: S
authors.initials: S
authors.lastname: Ikehara
mesh_terms: D000368:Aged; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects*; D015703:Antigens, CD / Q000378:metabolism; D015214:Antigens, Differentiation, Myelomonocytic / Q000378:metabolism; D003875:Drug Eruptions / Q000209:etiology; D017809:Fatal Outcome; D005260:Female; D015726:Giant Cells / Q000473:pathology*; D006333:Heart Failure / Q000209:etiology* / Q000473:pathology; D006801:Humans; D007150:Immunohistochemistry; D009205:Myocarditis / Q000139:chemically induced* / Q000175:diagnosis / Q000378:metabolism; D009206:Myocardium / Q000378:metabolism / Q000473:pathology; D010666:Phenylpropionates / Q000009:adverse effects*; D013902:Radiography, Thoracic; D000097382:CD68 Molecule
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D015703:Antigens, CD; D015214:Antigens, Differentiation, Myelomonocytic; D010666:Phenylpropionates; C067980:CD68 antigen, human; D000097382:CD68 Molecule; C040656:loxoprofen