静脉注射免疫球蛋白和类固醇治疗后急性暴发性心肌炎的快速缓解
Rapid Resolution of Acute Fulminant Myocarditis after IVIG and Steroid Treatment.
作者信息
Barrie Michael, McKnight Lucas, Solanki Pallavi
机构信息
Department of Emergency Medicine, The Ohio State University Wexner Medical Center, Columbus, OH 43210, USA.
Department of Internal Medicine and Department of Pediatrics, The Ohio State University Wexner Medical Center, Columbus, OH 43210, USA.
出版信息
Case Rep Crit Care. 2012;2012:262815. doi: 10.1155/2012/262815. Epub 2012 Dec 4.
We report a case of a 59-year-old woman who presented with worsening dyspnea which rapidly progressed to severe heart failure. Coronary arteries showed no obstruction. Supportive measures stabilized the patient's hemodynamics. Initially intravenous solumedrol was given, but when the patient's condition continued to deteriorate, intravenous immunoglobulin (IVIG) was added to the treatment regimen and her condition improved. Studies show no benefit to using immunosuppressive agents in viral myocarditis, but benefits have been demonstrated in other etiologies. Patients presenting with acute fulminant myocarditis with unknown etiology that continue to deteriorate with aggressive heart failure treatment may benefit from steroids and IVIG.
我们报告了一例59岁女性患者，该患者出现呼吸困难加重，迅速进展为严重心力衰竭。冠状动脉未显示阻塞。支持性措施稳定了患者的血流动力学。最初给予静脉注射甲泼尼龙，但当患者病情持续恶化时，静脉注射免疫球蛋白（IVIG）被添加到治疗方案中，她的病情得到改善。研究表明，在病毒性心肌炎中使用免疫抑制剂没有益处，但在其他病因中已证明有好处。对于病因不明的急性暴发性心肌炎患者，在积极的心力衰竭治疗下仍持续恶化，可能受益于类固醇和IVIG。
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