Giant Cell Myocarditis Responding to Immunosuppressive Therapy*
- Andrea Frustaci, MD, FCCP,
- Cristina Chimenti, MD,
- Maurizio Pieroni, MD, and
- Nicola Gentiloni, MD
Abstract
An unusual case of giant cell myocarditis presenting with cardiogenic shock that dramatically responded to conventional dose of steroids and azathioprine is reported. Cardiac recovery was rapid, complete (left ventricular ejection fraction rose to 55% from 10%), and was accompanied by the disappearance of the inflammatory infiltrates including giant cells in the control endomyocardial biopsy. Maintenance of the recovery at 16 months of follow-up on a low dose of azathioprine suggests that giant cell myocarditis might be a heterogeneous disease having either a negative untreatable trend necessitating cardiac transplantation, or a curable substrate responding to immunosuppressive drugs.
Footnotes
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Abbreviations: EF = ejection fraction; LV = left ventricular; LVEF = left ventricular ejection fraction
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- Accepted September 21, 1999.
- Received May 10, 1999.
