Author + information
- Received October 2, 2009
- Accepted October 26, 2009
- Published online August 31, 2010.
Giant cell myocarditis (GCM) is a rare myocarditis (1). The relationship between GCM and Coxsackievirus B (CVB) infection has not been documented yet. A 40-year-old woman was admitted because of palpitations and dizziness for 4 days. Two weeks earlier, she had a mild fever. Mechanical circulatory support was started because of recurrent ventricular tachycardia and progressive cardiogenic shock, and heart transplantation was done at day 10. Biopsy of the left atrium at day 5 showed severe inflammation and myocardial necrosis (A, arrows)with multinucleated giant cells (B, arrows), and enteroviral VP1 protein was detected in immunohistochemistry (C, arrows). By reverse transcriptase–polymerase chain reaction, CVB VP1 ribonucleic acid could be detected in all chambers of the explanted heart at day 10 (D, upper panel). The titers of neutralization antibody for CVB3 in the patient's serum at 7 days were increased >8 times that at 1 day. Although this case demonstrated the association of CVB and GCM for the first time, the possible coincidence of CVB fulminant myocarditis (2) and GCM could not be completely excluded.
- Received October 2, 2009.
- Accepted October 26, 2009.
- American College of Cardiology Foundation