Combined immunosuppression for the treatment of idiopathic giant cell myocarditis

Vanessa V. Menghini, Vladimir Savcenko, Lyle J. Olson, Henry D. Tazelaar, G. William, Andrew Kao, Leslie T Jr. Cooper

Research output: Contribution to journalArticle

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Abstract

Giant cell myocarditis (GCM) is a rare and frequently fatal disorder with no proven treatment. Case reports and data from a rat model of GCM suggest that immunosuppressive therapy directed against T lymphocytes may have clinical benefit. We describe a 47-year-old man with severe acute heart failure due to GCM in whom the left ventricular ejection fraction normalized and the myocardial inflammatory infiltrate resolved rapidly after treatment with muromonab-CD3, cyclosporine, azathioprine, and corticosteroids. Three previously published cases with less impressive responses to treatment including muromonab-CD3 and a critical review of the published data on immunosuppressive therapy are included in this report. The response to immunosuppressive therapy is highly variable, and direct comparisons between immunosuppressive regimens do not exist. Therefore, despite individual reports of dramatic improvement after immunosuppressive treatment, firm conclusions cannot be made about the benefit of immunosuppression for GCM. The benefits of immunosuppressive therapy must be confirmed in a prospective, randomized trial.

Original languageEnglish (US)
Pages (from-to)1221-1226
Number of pages6
JournalMayo Clinic Proceedings
Volume74
Issue number12
StatePublished - 1999

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Myocarditis
Giant Cells
Immunosuppression
Immunosuppressive Agents
Muromonab-CD3
Therapeutics
Azathioprine
Stroke Volume
Cyclosporine
Adrenal Cortex Hormones
Heart Failure
T-Lymphocytes

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Menghini, V. V., Savcenko, V., Olson, L. J., Tazelaar, H. D., William, G., Kao, A., & Cooper, L. T. J. (1999). Combined immunosuppression for the treatment of idiopathic giant cell myocarditis. Mayo Clinic Proceedings, 74(12), 1221-1226.

Combined immunosuppression for the treatment of idiopathic giant cell myocarditis. / Menghini, Vanessa V.; Savcenko, Vladimir; Olson, Lyle J.; Tazelaar, Henry D.; William, G.; Kao, Andrew; Cooper, Leslie T Jr.

In: Mayo Clinic Proceedings, Vol. 74, No. 12, 1999, p. 1221-1226.

Research output: Contribution to journalArticle

Menghini, VV, Savcenko, V, Olson, LJ, Tazelaar, HD, William, G, Kao, A & Cooper, LTJ 1999, 'Combined immunosuppression for the treatment of idiopathic giant cell myocarditis', Mayo Clinic Proceedings, vol. 74, no. 12, pp. 1221-1226.
Menghini VV, Savcenko V, Olson LJ, Tazelaar HD, William G, Kao A et al. Combined immunosuppression for the treatment of idiopathic giant cell myocarditis. Mayo Clinic Proceedings. 1999;74(12):1221-1226.
Menghini, Vanessa V. ; Savcenko, Vladimir ; Olson, Lyle J. ; Tazelaar, Henry D. ; William, G. ; Kao, Andrew ; Cooper, Leslie T Jr. / Combined immunosuppression for the treatment of idiopathic giant cell myocarditis. In: Mayo Clinic Proceedings. 1999 ; Vol. 74, No. 12. pp. 1221-1226.
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