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Influenza Myocarditis Treated With Antithymocyte Globulin

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  • Influenza Myocarditis Treated With Antithymocyte Globulin

    Pediatrics. 2018 Oct 23. pii: e20180884. doi: 10.1542/peds.2018-0884. [Epub ahead of print]
    Influenza Myocarditis Treated With Antithymocyte Globulin.

    Piccininni JA1, Richmond ME2, Cheung EW2, Lee TM2, Law SP2, Addonizio LJ2, Zuckerman WA2.
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    Abstract

    Influenza is a cause of significant morbidity and mortality worldwide. Myocarditis is a rare complication of the virus and can vary widely in severity. The published cases of influenza B myocarditis in children tend to be severe with a high mortality rate. Current standard treatment of viral myocarditis is supportive care, although immunomodulatory therapies, such as steroids and intravenous immunoglobulin, are often used. T cells have been implicated in causing significant myocyte damage in myocarditis by leading to the downstream production of antibodies against viral and myocyte antigens; this has created a theoretical basis for the use of antithymocyte globulin to target T cells in these patients. We present a case of acute fulminant influenza B myocarditis in a pediatric patient that required mechanical circulatory support and improved only after treatment with antithymocyte globulin.


    PMID: 30352793 DOI: 10.1542/peds.2018-0884
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