Plasma Concentrations of Cytokines and Neurohumoral Factors in a Case of Fulminant Myocarditis Successfully Treated With Intravenous Immunoglobulin and Percutaneous Cardiopulmonary Support

DOI Web Site PubMed 被引用文献5件 参考文献26件
  • Abe Satoru
    Division of Cardiology, Hematology and Endocrinology/Metabolism, Niigata University Graduate School of Medical and Dental Sciences
  • Okura Yuji
    Division of Cardiology, Hematology and Endocrinology/Metabolism, Niigata University Graduate School of Medical and Dental Sciences
  • Hoyano Makoto
    Division of Cardiology, Hematology and Endocrinology/Metabolism, Niigata University Graduate School of Medical and Dental Sciences
  • Kazama Ryu
    Division of Cardiology, Hematology and Endocrinology/Metabolism, Niigata University Graduate School of Medical and Dental Sciences
  • Watanabe Satoru
    Division of Cardiology, National Defense Medical College
  • Ozawa Takuya
    Division of Cardiology, Hematology and Endocrinology/Metabolism, Niigata University Graduate School of Medical and Dental Sciences
  • Saigawa Takashi
    Division of Cardiology, Hematology and Endocrinology/Metabolism, Niigata University Graduate School of Medical and Dental Sciences
  • Hayashi Manabu
    Division of Cardiology, Hematology and Endocrinology/Metabolism, Niigata University Graduate School of Medical and Dental Sciences
  • Yoshida Tsuyoshi
    Division of Cardiology, Hematology and Endocrinology/Metabolism, Niigata University Graduate School of Medical and Dental Sciences
  • Tachikawa Hitoshi
    Division of Cardiology, Hematology and Endocrinology/Metabolism, Niigata University Graduate School of Medical and Dental Sciences
  • Kashimura Takeshi
    Division of Cardiology, Hematology and Endocrinology/Metabolism, Niigata University Graduate School of Medical and Dental Sciences
  • Suzuki Keisuke
    The Division of Cardiology and Internal Medicine, Sado General Hospital
  • Nagahashi Masayuki
    The Division of Thoracic and Cardiovascular Surgery, Niigata University Graduate School of Medical and Dental Sciences
  • Watanabe Junzo
    The Division of Thoracic and Cardiovascular Surgery, Niigata University Graduate School of Medical and Dental Sciences
  • Shimada Kouji
    The Division of Thoracic and Cardiovascular Surgery, Niigata University Graduate School of Medical and Dental Sciences
  • Hasegawa Go
    Department of Cellular Function Division of Cellular and Molecular Pathology, Niigata University Graduate School of Medical and Dental Sciences
  • Kato Kiminori
    Division of Cardiology, Hematology and Endocrinology/Metabolism, Niigata University Graduate School of Medical and Dental Sciences
  • Hanawa Haruo
    Division of Cardiology, Hematology and Endocrinology/Metabolism, Niigata University Graduate School of Medical and Dental Sciences
  • Kodama Makoto
    Division of Cardiology, Hematology and Endocrinology/Metabolism, Niigata University Graduate School of Medical and Dental Sciences
  • Aizawa Yoshifusa
    Division of Cardiology, Hematology and Endocrinology/Metabolism, Niigata University Graduate School of Medical and Dental Sciences

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A 53-year-old Japanese man with fulminant myocarditis was referred. Percutaneous cardiopulmonary support (PCPS) was introduced immediately and intravenous immunoglobulin (IVIG) therapy followed for 2 days. Cardiac function showed signs of recovery on the 4th hospital day and the patient was weaned from PCPS on the 7th hospital day. Creatine kinase-MB peaked at 12 h after admission and was 176 ng/ml. Endomyocardial biopsy showed active myocarditis. A marked increase of the neutralizing antibody titer suggested coxsackievirus B3 infection. Plasma concentrations of cytokines and neurohumoral factors were analyzed. Proinflammtory cytokines, such as interleukin (IL)-1β, IL-6 and tumor necrosis factor (TNF-α), and anti-inflammatory cytokines, such as IL-1 receptor antagonist, soluble TNF receptor-1 and IL-10, were elevated on admission and all had decreased on the 7th hospital day. Brain natriuretic peptide and noradrenaline were already elevated upon admission (1,940 pg/ml and 4.6 ng/ml, respectively) and decreased thereafter. Although IVIG therapy under PCPS is a common treatment for fulminant myocarditis, the immunological response in vivo remains unclear. This case demonstrated suppression of serum cytokines after IVIG and PCPS treatment. Immunological parameters in those who have been treated with IVIG and PCPS and survived without complications are of great value for evaluation of the therapy. Further analysis with more cases in a multicenter study is necessary. (Circ J 2004; 68: 1223 - 1226)<br>

収録刊行物

  • Circulation Journal

    Circulation Journal 68 (12), 1223-1226, 2004

    一般社団法人 日本循環器学会

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