Korean Circulation Journal

The Korean Society of Cardiology (대한심장학회)
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Endomyocardial Biopsy and Magnetic Resonance Imaging of Acute Myocarditis with Adult-Onset Still's Disease

  • Yamazoe, Masahiro (Division of Cardiology, St. Lukes International Hospital) ;
  • Mizuno, Atsushi (Division of Cardiology, St. Lukes International Hospital) ;
  • Suyama, Yasuhiro (Immuno Rheumatology Center, St. Lukes International Hospital) ;
  • Nishi, Yutaro (Division of Cardiology, St. Lukes International Hospital) ;
  • Suzuki, Koyu (Division of Pathology, St. Lukes International Hospital) ;
  • Niwa, Koichiro (Division of Cardiology, St. Lukes International Hospital) ;
  • Okada, Masato (Immuno Rheumatology Center, St. Lukes International Hospital)
  • Received : 2014.04.17
  • Accepted : 2014.06.09
  • Published : 2014.11.30
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Abstract

A 36-year-old female with a high-grade fever and epigastric abdominal pain was prescribed antibiotics, but developed hypoxia and dyspnea. An echocardiography revealed diffuse hypokinesis and massive pericardial effusion, after which diagnostic cardiac catheterization and an endomyocardial biopsy (EMB) were peformed to reveal fibrosis and infiltration of inflammation cells composed primarily of neutrophils. Clinical manifestation of a spiking fever, leukocytosis, elevated ferritin levels, skin rash and EMB findings led to a diagnosis of adult-onset Still's disease (AOSD) with acute myocarditis. Pulse therapy of intravenous methylprednisolone was performed for three days, followed by a daily dose of prednisone (60 mg). After a course of steroid therapy for fever and pericardial effusion, and conducting a left ventricular ejection fraction, the patient showed improvement and was discharged asymptomatic within 32 days of admission. This study is the first to report on a case of myocarditis in AOSD diagnosed by neutrophil infiltration in the myocardium.

Keywords

References

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Cited by

  1. Elevated Troponin Serum Levels in Adult Onset Still's Disease vol.2015, pp.None, 2015, https://doi.org/10.1155/2015/732095
  2. Myocarditis in Adult-Onset Still’s Disease: Case-Based Review vol.39, pp.3, 2014, https://doi.org/10.1007/s10067-019-04814-9