Pathology, Children's Hospital of Michigan, Detroit, Michigan, USA.
Department of Pathology, Children's Healthcare of Atlanta Inc, Atlanta, Georgia, USA.
Fetal Pediatr Pathol. 2021 Dec;40(6):691-696. doi: 10.1080/15513815.2020.1728792. Epub 2020 Mar 11.
Right ventricular myocardial fatty infiltration has been observed in pediatric cardiac allografts with an associated decrease in graft life expectancy. A possible explanation included an immunosuppressant drug effect which prompted us to examine common factors between non-cardiac transplanted immunosuppressed patients and postmortem hearts of pediatric patients who died of non-cardiac causes. Sixty-one of 1,030 pediatric autopsies were from immunosuppressed children who were treated with corticosteroids for malignant tumors, non-cardiac transplantations, or other chronic clinical conditions. 62 children who died for non-medical reasons served as controls. Cardiac H&E autopsy slides were examined for right ventricular fatty infiltration. There was a significant increase in right ventricular fatty infiltration in patients that were non-cardiac transplanted and immunosuppressed compared to controls. None of the index patients had other features of arrhythmogenic right ventricular dysplasia. Immunosuppression may lead to right ventricular fatty infiltration in childhood.
右心室心肌脂肪浸润已在儿科心脏移植物中观察到，这与移植物预期寿命的降低有关。一种可能的解释包括免疫抑制剂的药物作用，这促使我们研究非心脏移植免疫抑制患者和因非心脏原因死亡的儿科患者死后心脏之间的常见因素。在 1030 例儿科尸检中，有 61 例来自接受皮质类固醇治疗恶性肿瘤、非心脏移植或其他慢性临床疾病的免疫抑制儿童。62 例因非医疗原因死亡的儿童作为对照。检查了心脏 H&E 尸检切片的右心室脂肪浸润情况。与对照组相比，非心脏移植和免疫抑制的患者右心室脂肪浸润明显增加。没有一例指数患者有致心律失常性右室发育不良的其他特征。免疫抑制可能导致儿童右心室脂肪浸润。
