Acute viral myocarditis: role of immunosuppression: a prospective randomised study

  title={Acute viral myocarditis: role of immunosuppression: a prospective randomised study},
  author={Kalim Uddin Aziz and Najma Patel and Tareen Sadullah and Habiba Tasneem and Hasina Thawerani and Saeed Talpur},
  journal={Cardiology in the Young},
  pages={509 - 515}
Abstract Objective To conduct a prospective randomised study to show the efficacy of immune suppression with prednisolone, administered at the 3-month duration of acute myocarditis. Methods The diagnosis of acute viral myocarditis was made based on echocardiography and serum viral antibodies. The inclusion criterion was acute myocarditis of 3 months duration. In all, 68 of 173 children were available for randomisation into a prednisolone-treated group of 44 and a control group of 24 children… 

Corticosteroids and Intravenous Immunoglobulin in Pediatric Myocarditis: A Meta-Analysis

The present evidence does not support corticosteroids as superior to conventional therapy in children with myocarditis, and IVIG might be beneficial to improve LVEF and survival forMyocarditis in children.

Treating Pediatric Myocarditis with High Dose Steroids and Immunoglobulin

High dose steroids in conjunction with IVIG to treat acute myocarditis can be safe without significant infections or long-term side effects and had excellent recovery of ventricular function and survival without transplant.

Immunosuppressive Treatment for Myocarditis in the Pediatric Population: A Meta-Analysis

There may be a possible benefit, in the short term, to the addition of immunosuppressive therapy in the management of myocarditis in the pediatric population, however, further prospective investigation is warranted to validate this finding.

A Systematic Review Incorporating Meta-Analysis on the Effectiveness of Intravenous Immunoglobulin Versus Corticosteroids in the Treatment of Pediatric Myocarditis

The use of intravenous immunoglobulin might have an independent risk relationship with a lower mortality rate or heart transplantation and is recommended in children with myocarditis to prevent complications.

Immunosuppressive treatment for myocarditis: a meta-analysis of randomized controlled trials

Immunosuppressive treatment might be beneficial for improving left ventricular systolic function and remodeling in patients with myocarditis, which could be considered as a therapeutic alternative when optimal conventional therapy is not effective.

In-hospital and post-discharge outcomes of pediatric acute myocarditis underwent after high-dose steroid or intravenous immunoglobulin therapy

It was revealed that high-dose steroid or IVIG therapy had no significant effects on major in-hospital complications, late heart failure hospitalization, and long-term mortality.

Corticosteroids for viral myocarditis.

For people diagnosed with viral myocarditis and low LVEF, corticosteroids do not reduce mortality but they may improve cardiac function but the trials were of low quality and small size so this finding must be regarded as uncertain.

Management of acute myocarditis in children.

Myocarditis is a challenging diagnosis to make on clinical grounds and requires high index of suspicion, but the overall prognosis of the disease is good with survival rates up to 80%.



Immunosuppressive therapy in acute myocarditis: an 18 year systematic review

Current data suggest that immunosuppressive therapy does not significantly improve outcomes in children with acute myocarditis and there is insufficient evidence for its routine use.

Long term follow up of children with myocarditis treated by immunosuppression and of children with dilated cardiomyopathy

The high long term survival rate of this cohort of children with myocarditis is probably due to the effect of short term immunosuppression, which differs from previously published series of conventionally treated children, whose survival probability at one year was about 60.

Clinical outcome of acute myocarditis in children according to treatment modalities

There was no difference between the IVIG-treated patients and the control patients in the degree of recovery of left ventricular function and survival one year after the initial presentation.

Gamma-globulin treatment of acute myocarditis in the pediatric population.

It is suggested that use of high-dose IVIG for treatment of acute myocarditis is associated with improved recovery of left ventricular function and with a tendency to better survival during the first year after presentation.

Clinical outcomes of acute myocarditis in childhood

Good outcomes in paediatric patients presenting with acute heart failure secondary to acute lymphocytic myocarditis treated with immunosuppression are recorded, with the absence of significant arrhythmias, continued cardiac medications, or restrictions in physical activity.

Use of OKT3 for acute myocarditis in infants and children.

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Immune suppressive treatment in paediatric myocarditis: still awaiting the evidence

This study was set in an area where Chagas disease was endemic and the results are unlikely to apply to European and North American populations where entero-, adeno- and parvovirus infections predominate as causes of paediatric myocarditis.

Outcomes for children with acute myocarditis

In patients with biopsy-proven myocarditis, treatment with intravenous immune globulin appeared to confer no advantage to steroid therapy alone, and the need for randomised trials to assess the efficacy of current treatments, as well as that of new therapies is emphasised.