High-dose intravenous immunoglobulin in the treatment of acute myocarditis. A case report and review of the literature.

Abstract

A few reports have suggested the beneficial effect of high-dose intravenous immunoglobulin (IVIG) in the treatment of acute myocarditis and cardiomyopathy. We describe a 49-year-old woman in which acute myocarditis was diagnosed on the basis of clinical and echocardiographic findings. Conventional treatment with captopril and frusemide was administered: intravenous heparin and, subsequently, oral anticoagulants were added because of the appearance of an apical thrombus. On the fifth day of hospitalization, treatment with high-dose (400 mg kg(-1) day(-1)) IVIG was started and prosecuted for 5 days. A dramatic improvement of clinical conditions was observed, with increase of the left ventricular ejection fraction (LVEF) from 30% to 75% within 1 week. One year after the diagnosis the patient is in good health, with steady normal LVEF. The rapid recovery, which was immediately subsequent to the administration of high-dose IVIG, suggests that this kind of treatment has been effective in our patient with acute myocarditis.

• Authors: A Tedeschi, L Airaghi, S Giannini, L Ciceri, F M Massari
• Journal: Journal of internal medicine (J Intern Med) Vol. 251 Issue 2 Pg. 169-73 (Feb 2002) ISSN: 0954-6820 [Print] England
• PMID: 11905592 (Publication Type: Case Reports, Journal Article)

Topics

• Acute Disease
• Dose-Response Relationship, Drug
• Electrocardiography (drug effects)
• Female
• Humans
• Immunization, Passive
• Middle Aged
• Myocarditis (drug therapy, immunology)
• Treatment Outcome
• Ventricular Function, Left (drug effects)