Wang You-Yang, Shi Wen, Wang Jian, Li Yue, Tian Zhuang, Jiao Yang
Department of General Internal Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China.
Department of Gastroenterology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China.
World J Clin Cases. 2022 Sep 26;10(27):9750-9759. doi: 10.12998/wjcc.v10.i27.9750.
Although extraintestinal manifestations of inflammatory bowel disease (IBD) are well documented, myocarditis has only rarely been reported as an extraintestinal manifestation, and it can be fatal. The various clinical presentations and causes of myocarditis in IBD patients complicate making a correct and timely diagnosis.
Here we report a 15-year-old boy who presented with myocarditis as the initial presentation of a relapse of ulcerative colitis. In reviewing the literature for cases of myocarditis complicating IBD, we found 21 other cases, allowing us to expand our understanding of the clinical presentation, diagnosis, management, and outcomes of this rare condition. The most frequent diagnostic clues for myocarditis in IBD patients are dyspnea, chest pain, tachycardia, raised cardiac biomarkers, and abnormalities on trans-thoracic echocardiography. Additionally, we discuss the etiology of myocarditis in IBD patients, which include an extraintestinal manifestation, the adverse effects of mesalamine and infliximab, selenium deficiency, and infection, to help provide a framework for diagnosis and management.
Myocarditis as an extraintestinal manifestation of IBD can be life-threatening. Trans-thoracic echocardiogram and cardiac magnetic resonance may assist its diagnosis.
尽管炎症性肠病（IBD）的肠外表现已有充分记录，但心肌炎作为一种肠外表现却鲜有报道，且可能致命。IBD患者心肌炎的各种临床表现及病因使得正确及时诊断变得复杂。
在此，我们报告一名15岁男孩，以心肌炎作为溃疡性结肠炎复发的首发表现。在查阅有关IBD合并心肌炎病例的文献时，我们发现了另外21例病例，这使我们对这种罕见疾病的临床表现、诊断、治疗及预后有了更深入的了解。IBD患者心肌炎最常见的诊断线索是呼吸困难、胸痛、心动过速、心脏生物标志物升高以及经胸超声心动图异常。此外，我们还讨论了IBD患者心肌炎的病因，包括肠外表现、美沙拉嗪和英夫利昔单抗的不良反应、硒缺乏及感染，以帮助提供诊断和治疗框架。
心肌炎作为IBD的肠外表现可能危及生命。经胸超声心动图和心脏磁共振成像可能有助于其诊断。
