title: Successful immunoglobulin treatment for fulminant myocarditis and serial analysis of serum thioredoxin: a case report.
abstract: A 31-year-old woman suspected to have acute myocarditis was admitted to hospital and was managed with intra-aortic balloon pumping and a percutaneous cardiopulmonary support system because of sustained ventricular tachycardia. After immunoglobulin treatment, cardiac function and systematic inflammation were improved. The left ventricular endomyocardial biopsy revealed massive necrosis and degeneration of myocardial cells, and extensive infiltration of inflammatory cells. The clinicopathology of this patient was thought to be fulminant myocarditis. Serial serum thioredoxin (TRX) analysis showed that the serum level was high during the acute phase, and decreased during the chronic phase. Immunohistochemistry for TRX in the biopsy samples showed that inflammatory cells and cardiomyocytes were positively stained.
authors.affiliation: Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Japan.
authors.forename: Keisuke
authors.initials: K
authors.lastname: Shioji
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Matsuura
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Iwase
authors.forename: Shouji
authors.initials: S
authors.lastname: Kitaguchi
authors.forename: Hajime
authors.initials: H
authors.lastname: Nakamura
authors.forename: Junji
authors.initials: J
authors.lastname: Yodoi
authors.forename: Tetsuo
authors.initials: T
authors.lastname: Hashimoto
authors.forename: Chuichi
authors.initials: C
authors.lastname: Kawai
authors.forename: Chiharu
authors.initials: C
authors.lastname: Kishimoto
mesh_terms: D000208:Acute Disease; D000328:Adult; D015906:Angioplasty, Balloon, Coronary; D005260:Female; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use*; D007150:Immunohistochemistry; D009205:Myocarditis / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D009206:Myocardium / Q000737:chemistry / Q000473:pathology; D017180:Tachycardia, Ventricular / Q000209:etiology; D013879:Thioredoxins / Q000032:analysis / Q000097:blood*; D016896:Treatment Outcome
chemical_list: D016756:Immunoglobulins, Intravenous; D013879:Thioredoxins