title: Giant cell myocarditis successfully treated with antithymocyte globuline and extracorporeal membrane oxygenation for 21 days.
abstract: : A 31-year-old man presenting with cardiogenic shock and left ventricular ejection fraction of 10% received the diagnosis of giant cell myocarditis by endomyocardial biopsy. The patient was successfully treated with high-dose inotropes, intra-aortic balloon pump and venoarterial extracorporeal membrane oxygenation for 21 days associated with combined immunosuppression (thymoglobulin, steroids, cyclosporine). Immunosuppression including thymoglobulin is the regimen associated with the highest probability of recovery in case of giant cell myocarditis. Immunosuppression needs time to be effective; thus, hemodynamic support must be guaranteed. In the present case, we observed that full recovery can be obtained up to 21 days of support with extracorporeal membrane oxygenation and adequate immunosuppression.
authors: 'Angelo De Gasperis' Cardiothoracic and Vascular Department, Niguarda Ca' Granda Hospital, Milan, Italy.
authors: Enrico
authors: E
authors: Ammirati
authors: Fabrizio
authors: F
authors: Oliva
authors: Oriana
authors: O
authors: Belli
authors: Edgardo
authors: E
authors: Bonacina
authors: Patrizia
authors: P
authors: Pedrotti
authors: Fabio Maria
authors: FM
authors: Turazza
authors: Alberto
authors: A
authors: Roghi
authors: Roberto
authors: R
authors: Paino
authors: Luigi
authors: L
authors: Martinelli
authors: Maria
authors: M
authors: Frigerio
mesh_terms: D000328:Adult; D000961:Antilymphocyte Serum / Q000008:administration & dosage*; D001706:Biopsy; D002316:Cardiotonic Agents / Q000627:therapeutic use; D003131:Combined Modality Therapy; D015199:Extracorporeal Membrane Oxygenation; D015726:Giant Cells / Q000187:drug effects* / Q000276:immunology / Q000473:pathology; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage*; D007423:Intra-Aortic Balloon Pumping; D008279:Magnetic Resonance Imaging; D008297:Male; D009205:Myocarditis / Q000175:diagnosis / Q000276:immunology / Q000503:physiopathology / Q000628:therapy*; D020127:Recovery of Function; D012770:Shock, Cardiogenic / Q000175:diagnosis / Q000276:immunology / Q000628:therapy*; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000961:Antilymphocyte Serum; D002316:Cardiotonic Agents; D007166:Immunosuppressive Agents