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Rev Med Inst Mex Seguro Soc. 2016;54 Suppl 3:S296-S301.

[Effect of immune therapy in the prognosis of viral myocarditis in pediatric patients].

[Article in Spanish; Abstract available in Spanish from the publisher]

Author information

1
Servicio de Cardiopatías Congénitas, Hospital de Cardiología, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Ciudad de México. horacioinvestigacion@hotmail.com.

Abstract

in English, Spanish

BACKGROUND:

Myocarditis is the inflammation of the myocardial tissue, primarily caused by viral infection. Dilated cardiomyopathy (MD) is the most serious complication. Immunomodulatory therapy is not validated in these patients; however, it appears to offer benefits in the prognosis of this disease. The aim of this work was to determine the prognosis of immunomodulatory therapy in the development of MD in pediatric patients with viral myocarditis effect.

METHODS:

A retrospective cohort of patients between 4 and 17 years diagnosed with viral myocarditis was integrated. It was considered as the main exposure treatment, which was divided into two types: normal (drugs targeted for heart failure and antiviral exclusively) and immunomodulatory (hyperimmune immunoglobulin, azathioprine and prednisone plus usual treatment). Time between diagnosis and treatment, history of asystole and positive for enterovirus and adenovirus antibodies: as measured confounders. The follow-up was 48 months. The outcome variable was the MD (LV diastolic diameter > + 2 Z-score and positive biopsy).

RESULTS:

31 patients were obtained with a median of 5 (4-15) years; 6 received immunomodulatory therapy and regular rest. The MD was presented in 17% of patients exposed to immunomodulatory therapy vs. 35% traditional, with HR = 0.5 (0.1-0.7).

CONCLUSIONS:

Inmunodulatory therapy is a protective factor for MD in patients with viral myocarditis.

KEYWORDS:

Dilated cardiomyopathy; Myocarditis; Virus diseases

PMID:
27855053
[Indexed for MEDLINE]

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