Treatment of Fulminant Giant Cell Myocarditis Associated with Polymyositis Using a Left Ventricular Assist Device and Subsequent Corticosteroid and Immunosuppressive Therapy Leading to Remission

A 58-year-old man with a recent history of generalized myalgia and muscle weakness was transferred to our hospital because of acute progressive dyspnea. The patient underwent left ventricular (LV) assist device (LVAD) implantation due to cardiogenic shock with a LV ejection fraction (LVEF) of 6%. Th...

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Bibliographic Details
Published in:Internal Medicine 2017/08/15, Vol.56(16), pp.2155-2158
Main Authors: Ooka, Junichi, Tanaka, Hidekazu, Hatani, Yutaka, Tsuji, Yukio, Takeshige, Ryo, Mori, Shumpei, Matsumoto, Kensuke, Hara, Shigeo, Tanaka, Hiroshi, Okita, Yutaka, Hirata, Ken-ichi
Format: Article
Language:English
Subjects:
Case Report
corticosteroid therapy
Corticosteroids
Drug Therapy, Combination
Dyspnea
fulminant giant cell myocarditis
Giant cells
Giant Cells - pathology
Glucocorticoids - therapeutic use
Heart
Heart diseases
Heart-Assist Devices
Humans
Immunosuppressive agents
Immunosuppressive Agents - therapeutic use
immunosuppressive therapy
Implantation
Internal medicine
left ventricular assist device
Male
Middle Aged
Muscles
Myalgia
Myocarditis
Myocarditis - complications
Myocarditis - pathology
Myocarditis - therapy
Myocardium - pathology
Polymyositis
Polymyositis - complications
Polymyositis - pathology
Polymyositis - therapy
Remission
Remission Induction
Respiration
Shock, Cardiogenic - etiology
Shock, Cardiogenic - therapy
Ventricle
Ventricular Function, Left - physiology
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Description
Summary:A 58-year-old man with a recent history of generalized myalgia and muscle weakness was transferred to our hospital because of acute progressive dyspnea. The patient underwent left ventricular (LV) assist device (LVAD) implantation due to cardiogenic shock with a LV ejection fraction (LVEF) of 6%. The histological findings obtained from LV apex showed the infiltration of multinucleated giant cells and severe myocardial contusion. Combining this histological finding with our experienced neurologists comments, resulted in a final diagnosis of fulminant giant cell myocarditis associated with polymyositis. A day after LVAD implantation, the patient received corticosteroid and immunosuppressive therapy, and the LVEF recovered to 68%.
ISSN:0918-2918
1349-7235
DOI:10.2169/internalmedicine.8639-16