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ivig myocarditis

Frank H Morriss, Julie B Lindower, Heather L Bartlett, Dianne L Atkins, Jean O Kim, Jonathan M Klein, Bradley A Ford
Objective We describe five neonates with enteroviral (EV) infection to demonstrate central nervous system (CNS) and cardiac complications and report successful treatment of myocarditis with immunoglobulin intravenous (IVIG) in two. Study Design Case series identified during three enteroviral seasons in one neonatal intensive care unit (NICU) by cerebral spinal fluid (CSF) reverse transcriptase polymerase chain reaction (PCR) testing for EV in neonates suspected to have sepsis, but with sterile bacterial cultures...
July 2016: American Journal of Perinatology Reports
Sevim Karaaslan, Bülent Oran, Ümran Çalışkan, Tamer Baysal, Osman Başpınar, Ayşe Taş
The use of high-dose intravenous immunoglobulin (IVIG) has greatly increased in the last years. With broader use of immunoglobulin, the numbers of reported side effects are also growing. IVIG have also been used in the treatment of myocarditis and dilated cardiomyopathy. Here we reported a child with presumed acute myocarditis who has developed severe hemolytic anemia following high-dose IVIG administration. As our knowledge, this is the first case report with myocarditis or dilated cardiomyopathy who developed hemolytic anemia following high-dose IVIG administration...
December 5, 2003: Turkish Journal of Haematology: Official Journal of Turkish Society of Haematology
Chin-Yu Lin, Chien-Yi Hsu, Po-Hsun Huang
UNLABELLED: A 64-year-old man with rheumatoid arthritis (RA) presented to our emergency department with severe chest tightness and dyspnea. His electrocardiography (ECG) showed multiple premature atrial complexes (PACs) with wide QRS, and transthoracic echocardiography revealed severe hypokinesis of the left ventricle. The patient later developed sudden cardiovascular collapse with presumed fulminant myocarditis and cardiogenic shock. Further investigation showed that coronary angiogram, viral studies and autoimmune vasculitis markers were all negative...
November 2014: Acta Cardiol Sin
Kenichi Suga, Miki Inoue, Akemi Ono, Tomomasa Terada, Masami Kawahito, Kazuhiro Mori
Severe-type Kawasaki disease (KD) complicated by serious myocarditis and encephalopathy can be successfully treated without abnormality of the coronary arteries by steroid pulse treatment and intravenous immunoglobulin (IVIg). A 4-year-old Japanese girl was diagnosed with KD due to a 6-day history of fever, rash, flushed lips, conjunctival hyperemia, palmar edema, and cervical lymphadenopathy. The day after initiation of IVIg and aspirin, cardiac gallop rhythm was identified. Cardiac ultrasonography revealed severe left ventricular dysfunction...
2016: Journal of Medical Investigation: JMI
Surjit Singh, Sagar Bhattad, Anju Gupta, Deepti Suri, Amit Rawat, Manojkumar Rohit
Kawasaki disease (KD) is a common vasculitic disorder of childhood. Reported mortality in KD in Japan is 0.014%. We report the clinical and laboratory profile of 4 children who succumbed to KD during the period January 1994 to March 2015 at the Paediatric Allergy Immunology Unit, Advanced Paediatrics Centre, Post Graduate Institute of Medical Education and Research Centre, Chandigarh, India. A total of 460 children were diagnosed with KD based on the American Heart Association criteria. Male to female ratio was 1...
May 2016: Clinical and Experimental Rheumatology
Joan Robinson, Lisa Hartling, Ben Vandermeer, Terry P Klassen
BACKGROUND: This is an update of a previous review. Case reports and case series have described dramatic responses to intravenous immunoglobulin (IVIG) in people with presumed viral myocarditis, and its administration has become commonplace. OBJECTIVES: The primary objective of this review was to compare transplant-free survival of adults and children with presumed viral myocarditis treated with IVIG versus those who did not receive IVIG. A secondary objective was to determine if a group of patients with presumed viral myocarditis could be identified (on the basis of age, duration of symptoms, acuity of onset of symptoms, cardiac function at presentation, virological results or the presence or absence of histological evidence of acute myocarditis on cardiac biopsy in patients in whom a biopsy was performed) who would be the most likely to benefit from IVIG...
2015: Cochrane Database of Systematic Reviews
Daniel Phadke, Sonali S Patel, Samuel R Dominguez, Heather Heizer, Marsha S Anderson, Mary P Glode, Pei-Ni Jone
Kawasaki disease (KD) is characterized by myocarditis and left ventricular dysfunction during the acute phase of the illness. Despite treatment with intravenous immunoglobulin (IVIG), a significant number of patients are IVIG resistant. We evaluated KD patients in the acute phase of illness using tissue Doppler imaging (TDI) to assess whether myocardial dysfunction may predict IVIG resistance. All patients with acute KD presenting to Children's Hospital Colorado from February 2007 through March 2014 were included in this study and underwent echocardiograms with TDI evaluation at diagnosis...
December 2015: Pediatric Cardiology
Meng-Hsiu Yen, Yhu-Chering Huang, Min-Chi Chen, Ching-Chuan Liu, Nan-Chang Chiu, Reyin Lien, Luan-Yin Chang, Cheng-Hsun Chiu, Kuo-Chien Tsao, Tzou-Yien Lin
BACKGROUND: The benefits of intravenous immunoglobulin (IVIG) therapy for severe neonatal enterovirus infections are still controversial. OBJECT: To evaluate whether timing of IVIG administration might affect clinical outcomes of neonates with severe enteroviral infections. STUDY DESIGNS: We retrospectively analyzed 67 neonates with culture-confirmed severe enteroviral infection, defined as hepatitis with coagulopathy and thrombocytopenia...
March 2015: Journal of Clinical Virology: the Official Publication of the Pan American Society for Clinical Virology
Toshiaki Isogai, Hideo Yasunaga, Hiroki Matsui, Hiroyuki Tanaka, Hiromasa Horiguchi, Kiyohide Fushimi
BACKGROUND: Fulminant myocarditis (FM) is a rare but life-threatening disease. Intravenous immunoglobulin (IVIG) is not recommended for acute or chronic myocarditis in Western nations owing to the lack of rigorous evidence, but it is widely used in other countries, including Japan. This nationwide retrospective cohort study focused on evaluating the effect of IVIG in FM patients. METHODS AND RESULTS: Using the Diagnosis Procedure Combination database in Japan, we identified 603 FM patients aged ≥16 years who received mechanical circulatory support within 7 days after admission...
May 2015: Journal of Cardiac Failure
Summer Donovan, Gonzalo M L Bearman
Intravenous immunoglobulin (IVIG) has been suggested for the treatment of many ailments due to its ability to modulate the immune system and to provide passive immunity to commonly circulating pathogens. Its use as primary and adjunctive therapy for the treatment of conditions affecting critically ill patients is an attractive option, especially when alternative therapy does not exist. The body of literature on the use of IVIG for the treatment of several serious conditions, including sepsis, toxic shock syndrome, acute myocarditis, Stevens-Johnson syndrome, toxic epidermal necrolysis, and H1N1 influenza, were reviewed...
December 2014: Current Infectious Disease Reports
Michael Barrie, Lucas McKnight, Pallavi Solanki
We report a case of a 59-year-old woman who presented with worsening dyspnea which rapidly progressed to severe heart failure. Coronary arteries showed no obstruction. Supportive measures stabilized the patient's hemodynamics. Initially intravenous solumedrol was given, but when the patient's condition continued to deteriorate, intravenous immunoglobulin (IVIG) was added to the treatment regimen and her condition improved. Studies show no benefit to using immunosuppressive agents in viral myocarditis, but benefits have been demonstrated in other etiologies...
2012: Case Reports in Critical Care
Bernhard Maisch, Volker Ruppert, Sabine Pankuweit
Fulminant myocarditis is a clinical syndrome with signs of acute heart failure, cardiogenic shock, or life-threating rhythm disturbances in the context of suspected myocarditis. It is not an etiological diagnosis, but may have different underlying causes and pathogenetic processes - viral, bacterial, toxic, and autoreactive. Clinical management of the disease entity at the acute stage involves hemodynamic monitoring in an intensive care unit or similar setting. Rapid routine work-up is mandatory with serial EKGs, echocardiography, cardiac MRI, heart catheterization with endomyocardial biopsy for histology, immunohistology, and molecular analysis for the underlying infection and pathogenesis...
June 2014: Current Heart Failure Reports
Hazumu Nagata, Kenichiro Yamamura, Kiyoshi Uike, Yasutaka Nakashima, Yuichiro Hirata, Eiji Morihana, Yumi Mizuno, Shiro Ishikawa, Toshiro Hara
Pathologic studies of the heart in patients with Kawasaki disease (KD) revealed vasculitis, valvulitis, myocarditis, and pericarditis. However, there have been no studies on the quantitative determination of multi-site echogenicity of the heart in KD patients. It is also undetermined whether the degree of echogenicity of each site of the heart in patients with KD might be related to the response to intravenous immunoglobulin (IVIG) treatment. In 81 KD patients and 30 control subjects, we prospectively analyzed echogenicity of the heart...
August 2014: European Journal of Pediatrics
Jan M Orenstein
Kawasaki Disease (KD) is primarily a childhood vasculitis of mid-size muscular arteries, of which the coronary arteries (CA) are most clinically significant. Although timely treatment with pooled intravenous immunoglobulin (IVIG) has significantly reduced CA pathology, as determined by ECHO cardiology, about 30% of children still develop potentially fatal aneurysms, thrombi, or stenosis. This paper describes several additional pathologies and phenomena of undetermined significance, e.g. myocarditis, endocarditis with fibroelastosis, adrenal medullary necrosis, arterial smooth muscle cell transition into proliferating myofibroblasts, pneumonia in patients dying from KD, and calcification of organizing thrombi...
April 2014: Ultrastructural Pathology
Dan-Qing Yu, Ying Wang, Gui-Zhou Ma, Rong-He Xu, Zhi-Xiong Cai, Chu-Min Ni, Ping Chen, Zhi-Dan Zhu
Acute fulminant myocarditis (AFM) is a serious heart disease with limited treatment. This observational retrospective study aimed to investigate whether intravenous immunoglobulin (IVIG) was able to improve left ventricular function and reduce the episodes of arrhythmia in adult patients with AFM. The medical records of all patients with AFM who were admitted to the Critical Care Unit of Guangdong General Hospital (Guangzhou, China) between January 2001 and December 2010 were reviewed. A cohort of 58 patients was included in the study...
January 2014: Experimental and Therapeutic Medicine
E Young Bae, Eun Jung Lee, Seung Beom Han, Jae Young Lee, Dae Chul Jeong, Jin Han Kang
Enteroviral infection is one of the most common neonatal infections, and most patients recover without complications. This report describes a neonate who experienced meningitis followed by myocarditis. A 4-day-old boy was admitted with fever, diagnosed with enteroviral meningitis and treated with intravenous immunoglobulin (IVIG). However, myocarditis was subsequently diagnosed in spite of IVIG treatment, and coxsackievirus B1 (CXB1) was revealed as a cause. A left ventricular aneurysm persisted even though the patient recovered with repeated high-dose IVIG treatment and cardiac supportive care...
April 2014: Journal of Tropical Pediatrics
Joanne G Wildenbeest, Katja C Wolthers, Bart Straver, Dasja Pajkrt
Human parechoviruses (HPeVs) are closely related to human enteroviruses and exhibit many similarities in disease spectrum and symptoms. HPeV1 is most commonly associated with mild disease, but rare associations with severe disease such as myocarditis have been reported. Currently, no treatment is available for severe HPeV infections. In this case report we describe an infant with a severe, dilated cardiomyopathy in whom HPeV1 was revealed to be the only identifiable cause. The infant was treated with intravenous immunoglobulins (IVIGs) and recovered completely...
July 2013: Pediatrics
Chiharu Kishimoto, Keisuke Shioji, Tetsuo Hashimoto, Hiroshi Nonogi, Jong-Dae Lee, Shigeru Kato, Shinya Hiramitsu, Shin-ihiro Morimoto
Intravenous immunoglobulin (IVIG) therapy has been used to treat several autoimmune or inflammatory diseases. We conducted a clinical trial of immunoglobulin therapy for acute myocarditis. The study consisted of two projects: (1) a comparison of prognosis between patients treated with and those not treated with IVIG in a multi-center study; (2) analyses of inflammatory cytokines and blood cell profiles in a substudy. In (1), 15 patients were treated with IVIG (1-2 g/kg, over 2 days), whereas 26 were untreated...
May 2014: Heart and Vessels
Bernhard Maisch, Sabine Pankuweit
In inflammatory dilated cardiomyopathy and myocarditis, there is apart from heart failure and antiarrhythmic therapies no alternative to an etiologically driven specific treatment. Their prerequisites are noninvasive and invasive biomarkers including endomyocardial biopsy and PCR on cardiotropic agents. This review deals with the different etiologies of myocarditis and inflammatory cardiomyopathy including the genetic background, the predisposition for heart failure and inflammation. It analyses the epidemiologic shift in pathogenetic agents in the last 20 years, the role of innate and acquired immunity including the T cell and B cell driven immune responses...
November 2013: Heart Failure Reviews
Shirin Kalimuddin, October M Sessions, Yan'An Hou, Eng Eong Ooi, David Sim, Sivathasan Cumaraswamy, Teing Ee Tan, Siang Hui Lai, Chian Yong Low
Human parainfluenza virus (HPIV) infection as an aetiology of acute viral myocarditis is rare, with only few cases reported in the literature to date. Here we report a case of fulminant HPIV-2 myocarditis in a 47 year-old man with viraemia who was successfully treated with intravenous ribavirin and intravenous immunoglobulin (IVIG). There are currently no recommendations on the treatment of HPIV myocarditis. We are, to our knowledge, the first to report a patient with a documented HPIV-2 viraemia that subsequently cleared after the initiation of antiviral therapy...
January 2013: Journal of Clinical Virology: the Official Publication of the Pan American Society for Clinical Virology
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