Takayasu myocarditis mediated by cytotoxic T lymphocytes.
A 15-year-old Japanese man was referred for evaluation of heart failure. Conventional heart failure therapy had little effect, and severe left ventricular dysfunction as well as elevated erythrocyte sedimentation rate persisted. Magnetic resonance angiography showed aortic dilatation with wall thickening characteristic of Takayasu's arteritis. An endomyocardial biopsy specimen revealed infiltration of natural killer cells and gamma delta T lymphocytes, which play major roles in vascular injury of Takayasu's arteritis. Prednisolone administration provided great benefits to cardiac function. These findings suggest that autoimmune cytotoxic mechanisms similar to those in arterial tissue may contribute to cardiac impairment in Takayasu's arteritis.
Takeda
Norifumi
N
Department of Cardiovascular Medicine, University of Tokyo Graduate School of Medicine, Bunkyo-ku, Tokyo 113-8655.
Takahashi
Toshiyuki
T
Seko
Yoshinori
Y
Maemura
Koji
K
Nakasone
Hideki
H
Sakamoto
Kei
K
Hirata
Yasunobu
Y
Nagai
Ryozo
R
D000293:Adolescent; D001706:Biopsy; D005500:Follow-Up Studies; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D018810:Magnetic Resonance Angiography; D008297:Male; D009205:Myocarditis / Q000175:diagnosis / Q000188:drug therapy / Q000276:immunology*; D009206:Myocardium / Q000473:pathology; D011239:Prednisolone / Q000627:therapeutic use; D016176:T-Lymphocyte Subsets / Q000276:immunology*; D013602:T-Lymphocytes, Cytotoxic / Q000276:immunology*; D013625:Takayasu Arteritis / Q000150:complications* / Q000175:diagnosis / Q000276:immunology; D014057:Tomography, X-Ray Computed
D005938:Glucocorticoids; D011239:Prednisolone