Evaluation of the Diagnostic Work-Up in Children with Myocarditis and Idiopathic Dilated Cardiomyopathy
| Autor: | Michiel Dalinghaus, J. J. A. van Kampen, L. A. J. Rammeloo, A. D. J. ten Harkel, G. van Iperen, G J du Marchie Sarvaas, Ruben P J Meijer, S. L. den Boer, Ronald B. Tanke, B. Straver |
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| Přispěvatelé: | Pediatrics, Virology, Pediatric surgery, ICaR - Heartfailure and pulmonary arterial hypertension, Paediatric Cardiology |
| Jazyk: | angličtina |
| Rok vydání: | 2015 |
| Předmět: |
Cardiomyopathy
Dilated medicine.medical_specialty Myocarditis Biopsy CYTOMEGALOVIRUS Endomyocardial fibrosis CHILDHOOD Dilated cardiomyopathy Polymerase Chain Reaction Serology Internal medicine Idiopathic dilated cardiomyopathy medicine Humans Serologic Tests SUSPECTED MYOCARDITIS Children Diagnostics OUTCOMES medicine.diagnostic_test business.industry Myocardium CLINICAL-FEATURES Other Research Radboud Institute for Health Sciences [Radboudumc 0] Gold standard (test) medicine.disease Endomyocardial Fibrosis EUROPEAN-SOCIETY DYSFUNCTION CARDIOVASCULAR MAGNETIC-RESONANCE Pediatrics Perinatology and Child Health Etiology Cardiology HEART Cardiology and Cardiovascular Medicine business ENDOMYOCARDIAL BIOPSY Endocardium |
| Zdroj: | den Boer, S L, Meijer, R P J, van Iperen, G G, ten Harkel, A D J, Sarvaas, G J D, Straver, B, Rammeloo, L A J, Tanke, R B, van Kampen, J J A & Dalinghaus, M 2015, ' Evaluation of the Diagnostic Work-Up in Children with Myocarditis and Idiopathic Dilated Cardiomyopathy ', Pediatric Cardiology, vol. 36, no. 2, pp. 409-416 . https://doi.org/10.1007/s00246-014-1022-3 Pediatric cardiology, 36(2), 409-416. SPRINGER Pediatric Cardiology, 36, 409-16 Pediatric Cardiology, 36(2), 409-416. Springer New York Pediatric Cardiology, 36(2), 409-416 Pediatric Cardiology, 36, 2, pp. 409-16 Pediatric cardiology, 36(2), 409-416. Springer New York |
| ISSN: | 0172-0643 |
| Popis: | Contains fulltext : 155220.pdf (Publisher’s version ) (Closed access) The underlying etiology of dilated cardiomyopathy (DCM) in children varies, 14-22% is secondary to myocarditis, and the majority remains idiopathic. Etiology has prognostic value; however, 'a clinical diagnosis of myocarditis' has been frequently used because the gold standard [endomyocardial biopsy (EMB)] is often not performed. Therefore, a consistent diagnostic approach and interpretation is needed. In this multicenter study, we evaluated the diagnostic approach and interpretation of the viral results in children with myocarditis and idiopathic DCM. We included 150 children with DCM, of whom 103 were assigned the diagnosis myocarditis (n = 21) or idiopathic DCM (n = 82) by the attending physician. Viral tests were performed in 97/103 patients, in only 34% (n = 35) some of the tests were positive. Of those patients, we evaluated the probability of the assigned diagnosis using the viral test results. We classified viral test results as reflecting definite or probable myocarditis in 14 children and possible or unlikely myocarditis in 21 children. Based on this classification, 23% of patients were misclassified. We found that in children with DCM, the diagnostic approach varied and the interpretation was mainly based on viral results. Since a 'clinical diagnosis of myocarditis' has been frequently used in daily practice because of the lack of EMB results, a uniform protocol is needed. We propose to use viral test results in several steps (blood PCR, serology, PCR and/or cultures of the gastro-intestinal and respiratory tract, and EMB results) to estimate the probability of myocarditis. |
| Databáze: | OpenAIRE |
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