Department of Transplant Medicine, National Cerebral and Cardiovascular Center.
Department of Adult Cardiac Surgery, National Cerebral and Cardiovascular Center.
Circ J. 2020 Apr 24;84(5):815-819. doi: 10.1253/circj.CJ-19-0847. Epub 2020 Mar 14.
The therapeutic strategy for giant cell myocarditis (GCM) remains controversial, so we reviewed the clinical status of Japanese patients with GCM.
We retrospectively reviewed 6 consecutive patients with GCM requiring percutaneous mechanical circulatory support (p-MCS), with 3 further requiring ventricular assist devices. One patient died during p-MCS. Cardiac function improved in the other 5 with immunosuppressive therapy, but only 3 patients treated with dual immunosuppressants, including cyclosporine (CyA), achieved >1-year survival.
The prognosis of patients with fulminant GCM is poor, but a treatment that combines MCS and early administration of CyA-based immunosuppressants will be useful.
巨细胞心肌炎（GCM）的治疗策略仍存在争议，因此我们回顾了日本 GCM 患者的临床状况。
我们回顾性分析了 6 例连续接受经皮机械循环支持（p-MCS）的 GCM 患者，其中 3 例进一步需要心室辅助装置。1 例患者在 p-MCS 期间死亡。另外 5 例患者经免疫抑制治疗后心功能改善，但仅 3 例接受包括环孢素（CyA）在内的双免疫抑制剂治疗的患者存活时间超过 1 年。
暴发性 GCM 患者的预后较差，但联合 MCS 和早期使用 CyA 为基础的免疫抑制剂治疗将是有用的。
