Korean Circ J.  2019 Jan;49(1):115-117. 10.4070/kcj.2018.0305.

Clinical and Histological Response to Immunosuppressive Therapy in Giant Cell Myocarditis

Affiliations
  • 1Division of Cardiology, Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea. hyunjaicho@snu.ac.kr

Abstract

No abstract available.


MeSH Terms

Giant Cells*
Myocarditis*

Figure

  • Figure 1 Histological findings on endomyocardial biopsy. (A) Diffuse geographic myocarditis with severe necrotic change and inflammatory infiltrate (H&E, ×100). (B) Numerous multinucleated giant cells in nongranulomatous background. (C) Collection of inflammatory cells including variable numbers of giant cells (arrows), histiocyte, T-lymphocyte, and eosinophils. (D) The area with necrotic change and severe inflammation showed negative of desmin. (E) Histiocyte infiltration in myocardium (CD68 staining). (F) T-lymphocyte infiltrate in myocardium (CD3, Pan-T cell marker staining).H&E = hematoxylin and eosin.

  • Figure 2 Follow-up endomyocardial biopsy. (A) On 12th day from starting immunosuppressive therapy, myocardial biopsy revealed a marked reduction of the inflammatory infiltrate and the absence of giant cells. The fibrotic and fatty change are seen in the area, where there was necrotic change before treatment (H&E, ×200). (B) On 46th day, massive granulation tissue and fatty change without active myocardial damage was observed (H&E, ×400).H&E = hematoxylin and eosin.


Reference

1. Fluschnik N, Escher F, Blankenberg S, Westermann D. Fatal recurrence of fulminant giant cell myocarditis and recovery after initialisation of an alternative immunosuppressive regime. BMJ Case Rep. 2014; 2014:bcr2014206386.
2. Vaideeswar P, Cooper LT. Giant cell myocarditis: clinical and pathological features in an Indian population. Cardiovasc Pathol. 2013; 22:70–74. PMID: 22863545.
3. Kodama M, Matsumoto Y, Fujiwara M, Masani F, Izumi T, Shibata A. A novel experimental model of giant cell myocarditis induced in rats by immunization with cardiac myosin fraction. Clin Immunol Immunopathol. 1990; 57:250–262. PMID: 2208806.
4. Weimer R, Staak A, Süsal C, et al. ATG induction therapy: long-term effects on Th1 but not on Th2 responses. Transpl Int. 2005; 18:226–236. PMID: 15691277.
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