title: Pediatric myocarditis: A sentinel of non-cardiac chronic diseases?
abstract: BACKGROUND
  Although long-term outcome studies in large pediatric myocarditis/cardiomyopathy populations have been reported in literature, none of them focused on comorbidities.
  
  
  METHODS
  All children and adolescents (age <18 years) treated with myocarditis at the Department of Pediatrics, University of Debrecen, Hungary were followed. Patients suffering from myocarditis during the period 1996-2011 were enrolled.
  
  
  RESULTS
  Over the 16-year period, a diagnosis of myocarditis was established in nine children. Their median age was 1.11 (0.03-8.71) years. Three of the nine patients died. Left ventricular dilatation and ejection fraction normalized within 1-21 months in the survivors. None of the cases progressed to dilated cardiomyopathy. Regarding non-cardiac comorbidities, myocarditis or recurrent peri-myocarditis preceded the manifestation of celiac disease in two patients, while cystic fibrosis was diagnosed after the improvement of cardiac function in another, and Alström syndrome was diagnosed several years after complete recovery from myocarditis in yet another patient.
  
  
  CONCLUSIONS
  These results suggest that manifestations of other chronic pediatric diseases may be more frequent among survivors of pediatric myocarditis. Prolonged follow-up of patients who survive myocarditis is therefore recommended not only to detect possible progression to cardiomyopathy but also to identify non-cardiac comorbidities.
authors.forename: Gábor
authors.initials: G
authors.lastname: Mogyorósy
authors.forename: Enikő
authors.initials: E
authors.lastname: Felszeghy
authors.forename: Tamás
authors.initials: T
authors.lastname: Kovács
authors.forename: Andrea
authors.initials: A
authors.lastname: Berkes
authors.forename: László
authors.initials: L
authors.lastname: Tóth
authors.forename: György
authors.initials: G
authors.lastname: Balla
authors.forename: Ilma
authors.initials: I
authors.lastname: Korponay-Szabó
keywords: Alström syndrome; Kawasaki disease; celiac disease; child; cystic fibrosis; myocarditis