Giant cell myocarditis in a young man responsive to T-lymphocyte cytolytic therapy.
We describe a case of a 40-year-old man who presented with recent-onset, rapidly decompensating heart failure, and who was found to have giant cell myocarditis (GCM) on biopsy. The patient responded to myocardial rest on a biventricular assist device, as well as immunosuppression that included eradication of T cells using OKT3 therapy, coupled with high-dose steroids. The patient was successfully weaned off mechanical support, and ultimately discharged home, where he continues to do well. Based on a review of the clinical and experimental literature, we believe treatment with T-lymphocytic cytolytic therapy may be beneficial. Further studies using this therapy in the treatment of GCM are warranted.
Pinderski
Laura J
LJ
Division of Cardiology, UCLA Medical Center, Los Angeles, California, USA. lpinder@uab.edu
Fonarow
Gregg C
GC
Hamilton
Michele
M
Fishbein
Michael C
MC
Marelli
Daniel
D
Moriguchi
Jaime
J
Cohen
Benjamin
B
Kobashigawa
Jon A
JA
D000328:Adult; D003602:Cytotoxicity, Immunologic; D015726:Giant Cells / Q000473:pathology*; D006353:Heart-Assist Devices; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D007167:Immunotherapy / Q000379:methods*; D008297:Male; D016853:Muromonab-CD3 / Q000627:therapeutic use*; D009205:Myocarditis / Q000276:immunology / Q000473:pathology / Q000628:therapy*; D013601:T-Lymphocytes / Q000276:immunology*; D016896:Treatment Outcome
D007166:Immunosuppressive Agents; D016853:Muromonab-CD3