Sunday, April 30, 2017

Giant cell myocarditis review

A few points of interest form the paper:

Historically, GCM and cardiac sarcoidosis were often conflated, as both presented in similarly aged patients and could result in a myocarditis characterized by giant cells and granulomas. However, it has since been established that the two are distinct clinicopathologic entities with significant differences in presentation, histologic features, and prognosis…

The disease course is rapid, with a median time of 3 weeks from symptom onset to hospital presentation.6 While GCM appears to have no sex predilection, approximately 20% of cases occur in patients with an autoimmune disorder such as inflammatory bowel disease, celiac disease, thyroiditis, or rheumatoid arthritis—among others.4,10,11 Some cases of GCM are associated with tumors, most often thymoma and lymphoma…

Without appropriate immunosuppressive therapy, the median survival from GCM symptom onset to death or transplant is only 3 months.6 With appropriate immunosuppressive therapy, the 5-year survival rate free of transplant ranges from 52% to 72%.11,15 While the optimal immunosuppressive regimen remains to be defined, a combined double- or triple-drug cyclosporine-based therapy reportedly leads to a partial clinical remission in two-thirds of patients….

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