Vercek Gregor, Markelj Gasper, Mlakar Gorazd, Primec Zvonka Rener, Bertok Sara, Writzl Karin, Stefanija Magdalena Avbelj, Bajic Stevan, Vesel Samo, Ihan Alojz, Stritar Albin, Pokorn Marko, Kovac Jernej, Debeljak Marusa, Vidmar Ivan, Avcin Tadej, Grosek Stefan
Division of Surgery, Department of Paediatric Surgery and Intensive Therapy, University Medical Centre Ljubljana, Ljubljana, Slovenia.
Division of Paediatrics, Department of Allergology, Rheumatology and Clinical Immunology, University Medical Centre Ljubljana, Ljubljana, Slovenia.
Klin Padiatr. 2019 Mar;231(2):80-86. doi: 10.1055/a-0831-2593. Epub 2019 Mar 14.
Recurrent myocarditis is rare with only few reports having been published for paediatric cases. Repeated use of extracorporeal membrane oxygenation is also uncommon. In this paper we will present a very rare case of a 7-year old girl with recurrent fulminant myocarditis with heart failure requiring cardiopulmonary resuscitation and mechanical circulatory support with extracorporeal membrane oxygenation. Both episodes were precipitated by a viral upper respiratory tract infection, and in both cases the cardiac function eventually completely recovered. The second episode of fulminant myocarditis was particularly complex with markedly elevated markers of myocardiocytolysis, multiorgan dysfunction and the need for prolonged mechanical circulatory support. Nevertheless, the patient made a remarkable recovery. A comprehensive diagnostic workup pointed towards an aberrant immune response as the likely cause of the girl's susceptibility for fulminant myocarditis.
复发性心肌炎较为罕见，儿科病例仅有少数报道。反复使用体外膜肺氧合也不常见。在本文中，我们将介绍一例非常罕见的病例，一名7岁女孩患有复发性暴发性心肌炎并伴有心力衰竭，需要进行心肺复苏以及使用体外膜肺氧合进行机械循环支持。两次发作均由病毒性上呼吸道感染诱发，且在这两例中，心脏功能最终都完全恢复。第二次暴发性心肌炎发作情况尤为复杂，心肌细胞溶解标志物显著升高、出现多器官功能障碍且需要长时间的机械循环支持。尽管如此，患者仍实现了显著康复。全面的诊断检查表明，异常免疫反应可能是该女孩易患暴发性心肌炎的原因。
