Recurrent autoimmune myocarditis in a young woman during the coronavirus disease 2019 pandemic
Abstract We report a unique case of a young woman with recurrent immune‐mediated (virus‐negative) lymphocytic fulminant myocarditis during the coronavirus disease 2019 pandemic. At the first endomyocardial biopsy (EMB)‐proven episode, she had concomitant pneumonia, and a temporary biventricular assi...
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doaj-d5ac4a7097d04833aa4f47cac165a0972021-03-31T03:15:45ZengWileyESC Heart Failure2055-58222021-02-018175676010.1002/ehf2.13028Recurrent autoimmune myocarditis in a young woman during the coronavirus disease 2019 pandemicRaphael Caraffa0Renzo Marcolongo1Tomaso Bottio2Stefania Rizzo3Olimpia Bifulco4Lorenzo Bagozzi5Augusto D'Onofrio6Alida L.P. Caforio7Vjola Jorgji8Cristina Basso9Gino Gerosa10Cardiac Surgery, Department of Cardiological Thoracic and Vascular Sciences and Public Health University of Padua Padua ItalyHaematology and Clinical Immunology Unit and Cardio‐Immunology Outpatient Clinic University of Padua Padua ItalyCardiac Surgery, Department of Cardiological Thoracic and Vascular Sciences and Public Health University of Padua Padua ItalyCardiovascular Pathology Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health University of Padua Via Giustiniani, 2 Padua 36100 ItalyCardiac Surgery, Department of Cardiological Thoracic and Vascular Sciences and Public Health University of Padua Padua ItalyCardiac Surgery, Department of Cardiological Thoracic and Vascular Sciences and Public Health University of Padua Padua ItalyCardiac Surgery, Department of Cardiological Thoracic and Vascular Sciences and Public Health University of Padua Padua ItalyHaematology and Clinical Immunology Unit and Cardio‐Immunology Outpatient Clinic University of Padua Padua ItalyHacohen Lab Massachusetts General Hospital Boston MA USACardiovascular Pathology Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health University of Padua Via Giustiniani, 2 Padua 36100 ItalyCardiac Surgery, Department of Cardiological Thoracic and Vascular Sciences and Public Health University of Padua Padua ItalyAbstract We report a unique case of a young woman with recurrent immune‐mediated (virus‐negative) lymphocytic fulminant myocarditis during the coronavirus disease 2019 pandemic. At the first endomyocardial biopsy (EMB)‐proven episode, she had concomitant pneumonia, and a temporary biventricular assist device implant was followed by complete and long‐lasting cardiac recovery. Five years later, she was re‐admitted for relapsing cardiogenic shock with a recent history of pneumonia. She was treated with extracorporeal life support with apical venting for left ventricular unloading, and full recovery was achieved. Despite negative seriate nasopharyngeal swabs and EMB during hospitalization, an antibody positivity for severe acute respiratory syndrome coronavirus 2 was discovered after 4 weeks from discharge. This is the first report of an EMB‐proven, immune‐mediated (virus‐negative) recurrence of fulminant myocarditis. We hypothesize that in patients with a predisposing immunogenetic background, autoimmune disease may be triggered or reactivated by major infections, for example, pneumonia, that may act as adjuvants leading to an immune‐mediated hyper‐response.https://doi.org/10.1002/ehf2.13028fulminant myocarditisrecurrent myocarditisvirus‐negative lymphocytic myocarditis |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Raphael Caraffa Renzo Marcolongo Tomaso Bottio Stefania Rizzo Olimpia Bifulco Lorenzo Bagozzi Augusto D'Onofrio Alida L.P. Caforio Vjola Jorgji Cristina Basso Gino Gerosa |
spellingShingle |
Raphael Caraffa Renzo Marcolongo Tomaso Bottio Stefania Rizzo Olimpia Bifulco Lorenzo Bagozzi Augusto D'Onofrio Alida L.P. Caforio Vjola Jorgji Cristina Basso Gino Gerosa Recurrent autoimmune myocarditis in a young woman during the coronavirus disease 2019 pandemic ESC Heart Failure fulminant myocarditis recurrent myocarditis virus‐negative lymphocytic myocarditis |
author_facet |
Raphael Caraffa Renzo Marcolongo Tomaso Bottio Stefania Rizzo Olimpia Bifulco Lorenzo Bagozzi Augusto D'Onofrio Alida L.P. Caforio Vjola Jorgji Cristina Basso Gino Gerosa |
author_sort |
Raphael Caraffa |
title |
Recurrent autoimmune myocarditis in a young woman during the coronavirus disease 2019 pandemic |
title_short |
Recurrent autoimmune myocarditis in a young woman during the coronavirus disease 2019 pandemic |
title_full |
Recurrent autoimmune myocarditis in a young woman during the coronavirus disease 2019 pandemic |
title_fullStr |
Recurrent autoimmune myocarditis in a young woman during the coronavirus disease 2019 pandemic |
title_full_unstemmed |
Recurrent autoimmune myocarditis in a young woman during the coronavirus disease 2019 pandemic |
title_sort |
recurrent autoimmune myocarditis in a young woman during the coronavirus disease 2019 pandemic |
publisher |
Wiley |
series |
ESC Heart Failure |
issn |
2055-5822 |
publishDate |
2021-02-01 |
description |
Abstract We report a unique case of a young woman with recurrent immune‐mediated (virus‐negative) lymphocytic fulminant myocarditis during the coronavirus disease 2019 pandemic. At the first endomyocardial biopsy (EMB)‐proven episode, she had concomitant pneumonia, and a temporary biventricular assist device implant was followed by complete and long‐lasting cardiac recovery. Five years later, she was re‐admitted for relapsing cardiogenic shock with a recent history of pneumonia. She was treated with extracorporeal life support with apical venting for left ventricular unloading, and full recovery was achieved. Despite negative seriate nasopharyngeal swabs and EMB during hospitalization, an antibody positivity for severe acute respiratory syndrome coronavirus 2 was discovered after 4 weeks from discharge. This is the first report of an EMB‐proven, immune‐mediated (virus‐negative) recurrence of fulminant myocarditis. We hypothesize that in patients with a predisposing immunogenetic background, autoimmune disease may be triggered or reactivated by major infections, for example, pneumonia, that may act as adjuvants leading to an immune‐mediated hyper‐response. |
topic |
fulminant myocarditis recurrent myocarditis virus‐negative lymphocytic myocarditis |
url |
https://doi.org/10.1002/ehf2.13028 |
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