Case report of heart transplantation for giant cell myocarditis in a patient with common variable immunodeficiency
| Autor: | John M. Nicklas, Thomas A Franzon, Anna Kovalszki, Raja Rabah |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Heart transplantation
Pathology medicine.medical_specialty Cardiomyopathy business.industry Common variable immunodeficiency medicine.medical_treatment Acute heart failure Ehjcr/41 medicine.disease Giant cell myocarditis Ehjcr/45 Ehjcr/43 Case report Ehjcr/35 medicine Grand Round AcademicSubjects/MED00200 Heart transplant Cardiology and Cardiovascular Medicine business |
| Zdroj: | European Heart Journal: Case Reports |
| ISSN: | 2514-2119 |
| DOI: | 10.1093/ehjcr/ytab447 |
| Popis: | Background Solid-organ transplantation in patients with common variable immunodeficiency (CVID) is controversial due to the risk for severe and recurrent infections. Determining transplantation candidacy in CVID patients is further complicated by the presence of CVID-related non-infectious complications that can reduce overall survival and also recur in the transplanted organ. Data regarding solid organ transplantation in patients with CVID are limited, particularly in heart transplantation. Case summary A 32-year-old female with CVID presented with new heart failure after 3 months of dyspnoea on exertion. Her echocardiogram showed severe global systolic dysfunction with an ejection fraction of approximately 10%, and her right heart catheterization revealed severe biventricular pressure overload and severely reduced cardiac output. Endomyocardial biopsy revealed giant cells and mononuclear infiltrate consistent with giant cell myocarditis (GCM). Despite medical management, she developed progressive cardiogenic shock and underwent uncomplicated orthotopic heart transplantation on hospital Day 38. After 2 years of follow-up, she has had no major infectious complications and continues to have normal graft function with no recurrence of GCM. Conclusion We report a case of successful heart transplantation for GCM in a patient with CVID, with no major infectious complications after 2 years of follow-up. CVID should not be considered an absolute contraindication for heart transplantation. Graphical Abstract Graphical Abstract |
| Databáze: | OpenAIRE |
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