Marcolongo Renzo, Rizzo Stefania, Cerutti Alessia, Reffo Elena, Castaldi Biagio, Baritussio Anna, Basso Cristina, Di Salvo Giovanni, Caforio Alida L P
Hematology and Clinical Immunology, Department of Medicine, University of Padova, Padova, Italy.
Cardiovascular Pathology Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padova, Italy.
ESC Heart Fail. 2021 Apr;8(2):1604-1609. doi: 10.1002/ehf2.13163. Epub 2021 Jan 16.
The role of immunosuppressive therapy (IT) in paediatric autoimmune/immune-mediated myocarditis remains poorly defined. To explore its role, we present a series of three consecutive paediatric patients with biopsy-proven, virus negative, autoimmune/immune-mediated myocarditis, with distinct clinical and pathological features, who have been successfully treated with IT, a 14-year-old boy with Loeffler's fibroblastic parietal endomyocarditis, a 6-year-old child with celiac disease with chronic active lymphocytic myocarditis, and a 13-year-old boy with long-standing heart failure and active lymphocytic myocarditis. Patients started IT and entered follow-up between July 2017 and September 2019; the first patient completed IT. IT was associated with a substantial and sustained recovery of cardiac function in our patients, regardless of their heterogeneous clinical and pathological features. Combination IT was well tolerated and enabled tapering and weaning off steroids.
免疫抑制疗法（IT）在儿童自身免疫性/免疫介导性心肌炎中的作用仍不明确。为探讨其作用，我们报告了连续3例经活检证实、病毒阴性、具有不同临床和病理特征的自身免疫性/免疫介导性心肌炎的儿科患者，他们均接受IT治疗并取得成功，其中1例为14岁患有Loeffler纤维母细胞性心内膜炎的男孩，1例为6岁患有乳糜泻合并慢性活动性淋巴细胞性心肌炎的儿童，以及1例为13岁患有长期心力衰竭和活动性淋巴细胞性心肌炎的男孩。患者于2017年7月至2019年9月开始接受IT治疗并进入随访期；首例患者完成了IT治疗。无论患者具有何种异质性临床和病理特征，IT治疗均使我们的患者心脏功能得到显著且持续的恢复。联合IT治疗耐受性良好，能够逐渐减少并停用类固醇药物。
