Treatment of Fulminant Giant Cell Myocarditis Associated with Polymyositis Using a Left Ventricular Assist Device and Subsequent Corticosteroid and Immunosuppressive Therapy Leading to Remission

Junichi Ooka; Hidekazu Tanaka; Yutaka Hatani; Yukio Tsuji; Ryo Takeshige; Shumpei Mori; Kensuke Matsumoto; Shigeo Hara; Hiroshi Tanaka; Yutaka Okita; Ken-ichi Hirata

doi:10.2169/internalmedicine.8639-16

This article has now been updated. Please use the final version.

Treatment of Fulminant Giant Cell Myocarditis Associated with Polymyositis Using a Left Ventricular Assist Device and Subsequent Corticosteroid and Immunosuppressive Therapy Leading to Remission

Junichi Ooka, Hidekazu Tanaka, Yutaka Hatani, Yukio Tsuji, Ryo Takeshige, Shumpei Mori, Kensuke Matsumoto, Shigeo Hara, Hiroshi Tanaka, Yutaka Okita, Ken-ichi Hirata

Author information

Junichi Ooka
Division of Cardiovascular Medicine, Kobe University Graduate School of Medicine, Japan
Hidekazu Tanaka
Division of Cardiovascular Medicine, Kobe University Graduate School of Medicine, Japan
Yutaka Hatani
Division of Cardiovascular Medicine, Kobe University Graduate School of Medicine, Japan
Yukio Tsuji
Division of Neurology, Department of Internal Medicine, Kobe University Graduate School of Medicine, Japan
Ryo Takeshige
Division of Cardiovascular Medicine, Kobe University Graduate School of Medicine, Japan
Shumpei Mori
Division of Cardiovascular Medicine, Kobe University Graduate School of Medicine, Japan
Kensuke Matsumoto
Division of Cardiovascular Medicine, Kobe University Graduate School of Medicine, Japan
Shigeo Hara
Department of Diagnostic Pathology, Kobe University Graduate School of Medicine, Japan
Hiroshi Tanaka
Division of Cardiovascular Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Japan
Yutaka Okita
Division of Cardiovascular Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Japan
Ken-ichi Hirata
Division of Cardiovascular Medicine, Kobe University Graduate School of Medicine, Japan

Keywords: fulminant giant cell myocarditis, polymyositis, left ventricular assist device, corticosteroid therapy, immunosuppressive therapy

JOURNAL OPEN ACCESS Advance online publication

Article ID: 8639-16

DOI https://doi.org/10.2169/internalmedicine.8639-16

The final version of this article is now available: Vol. 56 (2017), No. 16 pp. 2155-2158

Details

Abstract

A 58-year-old man with a recent history of generalized myalgia and muscle weakness was transferred to our hospital because of acute progressive dyspnea. The patient underwent left ventricular (LV) assist device (LVAD) implantation due to cardiogenic shock with a LV ejection fraction (LVEF) of 6%. The histological findings obtained from LV apex showed the infiltration of multinucleated giant cells and severe myocardial contusion. Combining this histological finding with our experienced neurologists comments, resulted in a final diagnosis of fulminant giant cell myocarditis associated with polymyositis. A day after LVAD implantation, the patient received corticosteroid and immunosuppressive therapy, and the LVEF recovered to 68%.

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