tetano
Editor, Senior Moderator
ESC Heart Fail
. 2020 Nov 22.
doi: 10.1002/ehf2.13028. Online ahead of print.
Recurrent autoimmune myocarditis in a young woman during the coronavirus disease 2019 pandemic
Raphael Caraffa[SUP] 1 [/SUP], Renzo Marcolongo[SUP] 2 3 [/SUP], Tomaso Bottio[SUP] 1 [/SUP], Stefania Riza[SUP] 4 [/SUP], Olimpia Bifulco[SUP] 1 [/SUP], Lorenzo Bagozzi[SUP] 1 [/SUP], Augusto D'Onofrio[SUP] 1 [/SUP], Alida L P Caforio[SUP] 2 [/SUP], Vjola Jorgji[SUP] 5 [/SUP], Cristina Basso[SUP] 4 [/SUP], Gino Gerosa[SUP] 1 [/SUP]
Affiliations
Abstract
We report a unique case of a young woman with recurrent immune-mediated (virus-negative) lymphocytic fulminant myocarditis during the coronavirus disease 2019 pandemic. At the first endomyocardial biopsy (EMB)-proven episode, she had concomitant pneumonia, and a temporary biventricular assist device implant was followed by complete and long-lasting cardiac recovery. Five years later, she was re-admitted for relapsing cardiogenic shock with a recent history of pneumonia. She was treated with extracorporeal life support with apical venting for left ventricular unloading, and full recovery was achieved. Despite negative seriate nasopharyngeal swabs and EMB during hospitalization, an antibody positivity for severe acute respiratory syndrome coronavirus 2 was discovered after 4 weeks from discharge. This is the first report of an EMB-proven, immune-mediated (virus-negative) recurrence of fulminant myocarditis. We hypothesize that in patients with a predisposing immunogenetic background, autoimmune disease may be triggered or reactivated by major infections, for example, pneumonia, that may act as adjuvants leading to an immune-mediated hyper-response.
Keywords: fulminant myocarditis; recurrent myocarditis; virus-negative lymphocytic myocarditis.
. 2020 Nov 22.
doi: 10.1002/ehf2.13028. Online ahead of print.
Recurrent autoimmune myocarditis in a young woman during the coronavirus disease 2019 pandemic
Raphael Caraffa[SUP] 1 [/SUP], Renzo Marcolongo[SUP] 2 3 [/SUP], Tomaso Bottio[SUP] 1 [/SUP], Stefania Riza[SUP] 4 [/SUP], Olimpia Bifulco[SUP] 1 [/SUP], Lorenzo Bagozzi[SUP] 1 [/SUP], Augusto D'Onofrio[SUP] 1 [/SUP], Alida L P Caforio[SUP] 2 [/SUP], Vjola Jorgji[SUP] 5 [/SUP], Cristina Basso[SUP] 4 [/SUP], Gino Gerosa[SUP] 1 [/SUP]
Affiliations
- PMID: 33225579
- DOI: 10.1002/ehf2.13028
Abstract
We report a unique case of a young woman with recurrent immune-mediated (virus-negative) lymphocytic fulminant myocarditis during the coronavirus disease 2019 pandemic. At the first endomyocardial biopsy (EMB)-proven episode, she had concomitant pneumonia, and a temporary biventricular assist device implant was followed by complete and long-lasting cardiac recovery. Five years later, she was re-admitted for relapsing cardiogenic shock with a recent history of pneumonia. She was treated with extracorporeal life support with apical venting for left ventricular unloading, and full recovery was achieved. Despite negative seriate nasopharyngeal swabs and EMB during hospitalization, an antibody positivity for severe acute respiratory syndrome coronavirus 2 was discovered after 4 weeks from discharge. This is the first report of an EMB-proven, immune-mediated (virus-negative) recurrence of fulminant myocarditis. We hypothesize that in patients with a predisposing immunogenetic background, autoimmune disease may be triggered or reactivated by major infections, for example, pneumonia, that may act as adjuvants leading to an immune-mediated hyper-response.
Keywords: fulminant myocarditis; recurrent myocarditis; virus-negative lymphocytic myocarditis.