Comparison of the Clinical Presentation, Treatment, and Outcome of Fulminant and Acute Myocarditis in Children

DOI Web Site PubMed 被引用文献10件 参考文献81件
  • Saji Tsutomu
    The Scientific Committee, Japanese Society of Pediatric Cardiology & Cardiac Surgery Department of Pediatrics, Toho University Medical Center, Omori Hospital
  • Matsuura Hiroyuki
    Department of Pediatrics, Toho University Medical Center, Omori Hospital
  • Hasegawa Kei
    Department of Pediatrics, Toho University Medical Center, Omori Hospital
  • Nishikawa Toshio
    Department of Surgical Pathology, Tokyo Women's Medical University
  • Yamamoto Eiichi
    Department of Pediatrics, Ehime University
  • Ohki Hirotaka
    Department of Cardiology, Tokyo Metropolitan Children's Medical Center
  • Yasukochi Satoshi
    Department of Pediatric Cardiology, Nagano Children's Hospital
  • Arakaki Yoshio
    Department of Pediatrics, Kurashiki Central Hospital
  • Joo Kunio
    Department of Pediatrics, Kyushu Kosei Nenkin Hospital
  • Nakazawa Makoto
    The Scientific Committee, Japanese Society of Pediatric Cardiology & Cardiac Surgery Department of Pediatric Cardiology, Pediatric and Lifelong Congenital Cardiology Institute, Southern Tohoku General Hospital

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Background: Myocarditis (MC) is an important cause of cardiac dysfunction in children. Fulminant MC is sometimes fatal, and sequelae may develop during follow-up. We conducted a nationwide survey to determine the clinico-epidemiological features of MC in Japanese children and adolescents. Methods and Results: Survey questionnaires were mailed to 627 hospitals, which were asked if they had treated MC patients aged between 1 month and 17 years during the period from January 1997 through December 2002. Responses were collected until December 2005, and data were collected and analyzed until January 2008. A total of 169 patients were reported: 64 fulminant cases, 89 acute cases, and 8 chronic cases. Incidence was 43.5 cases/year and 0.26 cases/100,000. Pathogens were identified in 37 patients; coxsackie virus accounted for 60%. Major cardiovascular manifestations at onset were congestive heart failure, refractory arrhythmia, and syncope in 70, 37, and 17 patients, respectively. Intravenous immunoglobulin was administered to 73 patients. Mechanical support seemed to be effective and life-saving. Among the 169 patients, 123 survived. Cardiovascular sequelae were reported in 49 patients. Conclusions: The survival rate for children with fulminant MC was disappointing. Overall, two-thirds of survivors had no sequelae. Mechanical support may reduce the mortality and the risk of clinical worsening. (Circ J 2012; 76: 1222-1228)<br>

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  • Circulation Journal

    Circulation Journal 76 (5), 1222-1228, 2012

    一般社団法人 日本循環器学会

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