Biopsy-Proven Giant Cell Myocarditis Following the COVID-19 Vaccine - PubMed (original) (raw)

Biopsy-Proven Giant Cell Myocarditis Following the COVID-19 Vaccine

Kevin Sung et al. Circ Heart Fail. 2022 Apr.

No abstract available

Keywords: giant cells; heart failure; humans; myocarditis; vaccines.

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Figures

Figure 1.

Figure 1.

Heart biopsy with diffuse inflammation and myocyte damage. High magnification showing inflammatory infiltrate including giant cells (white arrow) and eosinophils (red arrows; A, ×10 hematoxylin and eosin stain; B and C, ×40 hematoxylin and eosin stain).

Figure 2.

Figure 2.

Electron microscopy showing tubuloreticular inclusions in capillary endothelial cells that have been seen in COVID-19–related collapsing glomerulopathy. A, ×4200; (B) ×60 000. Electron microscopy images were obtained by Jesus Macias, senior histotechnologist and electron microscopist at University of California San Diego Health.

Figure 3.

Figure 3.

Immunosuppression regimen for the patient. Initial regimen included methylprednisolone 1 g IV every 24 hours given for 3 doses. Week 1 regimen included tacrolimus with a goal trough of 12 to 15, mycophenolate mofetil 1000 mg BID, and prednisone taper starting at 60 mg daily. Once tacrolimus was at goal, mycophenolate mofetil was discontinued. Tacrolimus trough was stable for the first 4 months, but after developing complications, the goal trough was gradually decreased to 4 to 6. Prednisone was weaned from a starting dose of 60 mg daily to 5 mg daily. He remains on tacrolimus and prednisone at 10 months after diagnosis.

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References

    1. Kandolin R, Lehtonen J, Salmenkivi K, Räisänen-Sokolowski A, Lommi J, Kupari M. Diagnosis, treatment, and outcome of giant-cell myocarditis in the era of combined immunosuppression. Circ Heart Fail. 2013;6:15–22. doi: 10.1161/CIRCHEARTFAILURE.112.969261 -PubMed
    1. Gaillard F, Ismael S, Sannier A, Tarhini H, Volpe T, Greze C, Verpont MC, Zouhry I, Rioux C, Lescure FX, et al. Tubuloreticular inclusions in COVID-19-related collapsing glomerulopathy. Kidney Int. 2020;98:241. doi: 10.1016/j.kint.2020.04.022 -PMC -PubMed
    1. Cooper LT, Jr, Berry GJ, Shabetai R. Idiopathic giant-cell myocarditis–natural history and treatment. Multicenter Giant Cell Myocarditis Study Group investigators. N Engl J Med. 1997;336:1860–1866. doi: 10.1056/NEJM199706263362603 -PubMed
    1. Okura Y, Dec GW, Hare JM, Kodama M, Berry GJ, Tazelaar HD, Bailey KR, Cooper LT. A clinical and histopathologic comparison of cardiac sarcoidosis and idiopathic giant cell myocarditis. J Am Coll Cardiol. 2003;41:322–329. doi: 10.1016/s0735-1097(02)02715-8 -PubMed
    1. Ammirati E, Frigerio M, Adler ED, Basso C, Birnie DH, Brambatti M, Friedrich MG, Klingel K, Lehtonen J, Moslehi JJ, et al. Management of acute myocarditis and chronic inflammatory cardiomyopathy: an expert consensus document. Circ Heart Fail. 2020;13:e007405. doi: 10.1161/CIRCHEARTFAILURE.120.007405 -PMC -PubMed

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