白细胞介素 1 受体拮抗剂治疗期间全身型幼年特发性关节炎儿童发生致死性心肌炎。
Fatal myocarditis in a child with systemic onset juvenile idiopathic arthritis during treatment with an interleukin 1 receptor antagonist.
机构信息
Children's Hospital, Cleveland Clinic, Pediatric Rheumatology, 9500 Euclid Avenue/A111, Cleveland, OH 44195, USA.
出版信息
Pediatr Rheumatol Online J. 2012 Apr 10;10:8. doi: 10.1186/1546-0096-10-8.
BACKGROUND
The pathologic diagnosis of isolated myocarditis without pericardial involvement is uncommonly encountered in systemic onset Juvenile Idiopathic Arthritis (soJIA).
CASE
An eleven year-old boy with soJIA died suddenly while being treated with the interleukin 1 (IL-1) receptor inhibitor, anakinra. His autopsy revealed an enlarged heart and microscopic findings were consistent with myocarditis, but not pericarditis. Viral PCR testing performed on his myocardial tissue was negative.
CONCLUSION
This case illustrates myocarditis as a fatal complication of soJIA, potentially enabled by anakinra.
背景
孤立性心肌炎而无心包累及的病理诊断在全身型幼年特发性关节炎（soJIA）中不常见。
病例
一名 11 岁患有 soJIA 的男孩在接受白细胞介素 1（IL-1）受体抑制剂阿那白滞素治疗时突然猝死。尸检显示心脏增大，显微镜检查结果符合心肌炎，但不符合心包炎。对其心肌组织进行的病毒 PCR 检测为阴性。
结论
本病例说明心肌炎是 soJIA 的一种致命并发症，阿那白滞素可能使其恶化。
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