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A rare case of fulminant myocarditis succesfully treated with immunoglobulin therapy

Chiara Nalli, Christian Couture, Mathieu Bernier, Sébastien Bergeron, Bernard Cantin, Marie-Hélène Leblanc, Guy Proulx, Mario Sénéchal

Am J Case Rep 2010; 11:166-168

ID: 881158

Background: There is much debate over the role of immunosuppression in the treatment of acute fulminant myocarditis. The optimal treatment approach besides standard heart failure therapy and supportive care remains unclear. With conventional supportive therapy, with or without mechanical assist device, myocardial recovery is expected to take weeks to months. This is in contrast to the rapid improvement that can be observed in patients treated with immunotherapy.
Case Report: We report the case of an adult patient with fulminant myocarditis in whom cardiac function normalized within 2 days after high-dose intravenous immunoglobulin therapy (IVIG).
Conclusions: Therapy with IVIG may be a potentially useful treatment in selected patients if given early in the course of this disease. In presence of clinical presentation suggestive of fulminant myocarditis and lymphocytic myocarditis demonstrated by myocardial biopsy, IVIG should be considered.

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