Successful immunoglobulin treatment for fulminant myocarditis and serial analysis of serum thioredoxin: a case report.
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.
Shioji
Keisuke
K
Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Japan.
Matsuura
Yasushi
Y
Iwase
Tomoyuki
T
Kitaguchi
Shouji
S
Nakamura
Hajime
H
Yodoi
Junji
J
Hashimoto
Tetsuo
T
Kawai
Chuichi
C
Kishimoto
Chiharu
C
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
D016756:Immunoglobulins, Intravenous; D013879:Thioredoxins