Giant cell myocarditis successfully treated with

J Cardiovasc Med (Hagerstown) · Dec 2016

Case Reports

Giant cell myocarditis successfully treated with antithymocyte globuline and extracorporeal membrane oxygenation for 21 days.

: 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 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.

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- Enrico Ammirati, Fabrizio Oliva, Oriana Belli, Edgardo Bonacina, Patrizia Pedrotti, Fabio Maria Turazza, Alberto Roghi, Roberto Paino, Luigi Martinelli, and Maria Frigerio.
- 'Angelo De Gasperis' Cardiothoracic and Vascular Department, Niguarda Ca' Granda Hospital, Milan, Italy.
- J Cardiovasc Med (Hagerstown). 2016 Dec 1; 17 Suppl 2: e151-e153.
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.

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Giant cell myocarditis successfully treated with antithymocyte globuline and extracorporeal membrane oxygenation for 21 days.

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