Sirolimus for Recurrent Giant Cell Myocarditis After Heart Transplantation: A Unique Therapeutic Strategy.
Identifieur interne : 000166 ( Main/Exploration ); précédent : 000165; suivant : 000167Sirolimus for Recurrent Giant Cell Myocarditis After Heart Transplantation: A Unique Therapeutic Strategy.
Auteurs : Apurva D. Patel [États-Unis] ; Brian Lowes [États-Unis] ; Mohammed A. Chamsi-Pasha [États-Unis] ; Stanley J. Radio [États-Unis] ; Marshall Hyden [États-Unis] ; Ronald Zolty [États-Unis]Source :
- American journal of therapeutics [ 1536-3686 ]
Descripteurs français
- KwdFr :
- Adulte d'âge moyen (MeSH), Allogreffes (cytologie), Allogreffes (imagerie diagnostique), Allogreffes (immunologie), Association de médicaments (méthodes), Cellules géantes (immunologie), Coeur (imagerie diagnostique), Humains (MeSH), Imagerie par résonance magnétique (MeSH), Immunosuppresseurs (usage thérapeutique), Myocarde (cytologie), Myocarde (immunologie), Myocardite (diagnostic), Myocardite (thérapie), Mâle (MeSH), Rejet du greffon (diagnostic), Rejet du greffon (immunologie), Rejet du greffon (traitement médicamenteux), Récidive (MeSH), Résultat thérapeutique (MeSH), Sirolimus (usage thérapeutique), Transplantation cardiaque (effets indésirables), Échocardiographie (MeSH).
- MESH :
- cytologie : Allogreffes, Myocarde.
- diagnostic : Myocardite, Rejet du greffon.
- effets indésirables : Transplantation cardiaque.
- imagerie diagnostique : Allogreffes, Coeur.
- immunologie : Allogreffes, Cellules géantes, Myocarde, Rejet du greffon.
- méthodes : Association de médicaments.
- thérapie : Myocardite.
- traitement médicamenteux : Rejet du greffon.
- usage thérapeutique : Immunosuppresseurs, Sirolimus.
- Adulte d'âge moyen, Humains, Imagerie par résonance magnétique, Mâle, Récidive, Résultat thérapeutique, Échocardiographie.
English descriptors
- KwdEn :
- Allografts (cytology), Allografts (diagnostic imaging), Allografts (immunology), Drug Therapy, Combination (methods), Echocardiography (MeSH), Giant Cells (immunology), Graft Rejection (diagnosis), Graft Rejection (drug therapy), Graft Rejection (immunology), Heart (diagnostic imaging), Heart Transplantation (adverse effects), Humans (MeSH), Immunosuppressive Agents (therapeutic use), Magnetic Resonance Imaging (MeSH), Male (MeSH), Middle Aged (MeSH), Myocarditis (diagnosis), Myocarditis (therapy), Myocardium (cytology), Myocardium (immunology), Recurrence (MeSH), Sirolimus (therapeutic use), Treatment Outcome (MeSH).
- MESH :
- chemical , therapeutic use : Immunosuppressive Agents, Sirolimus.
- adverse effects : Heart Transplantation.
- cytology : Allografts, Myocardium.
- diagnosis : Graft Rejection, Myocarditis.
- diagnostic imaging : Allografts, Heart.
- drug therapy : Graft Rejection.
- immunology : Allografts, Giant Cells, Graft Rejection, Myocardium.
- methods : Drug Therapy, Combination.
- therapy : Myocarditis.
- Echocardiography, Humans, Magnetic Resonance Imaging, Male, Middle Aged, Recurrence, Treatment Outcome.
Abstract
CLINICAL FEATURES
Giant cell myocarditis (GCM) is a rare and a rapidly progressive disorder with fatal outcomes such that patients often require heart transplantation. We present a case of recurrent GCM in a transplanted patient with a history of Crohn disease requiring a novel therapeutic approach.
THERAPEUTIC CHALLENGE
After the orthotopic heart transplantation, GCM recurred on aggressive immunosuppression over the months, which included corticosteroids, basiliximab, tacrolimus, antithymocyte globulin, and rituximab. Although combination immunosuppressive therapy containing cyclosporine and 2-4 additional drugs including corticosteroids, azathioprine, mycophenolate mofetil, muromonab, gammaglobulin, or methotrexate have shown to prolong the transplant-free survival by keeping the disease under control, its role in preventing and treating recurrence posttransplantation is unclear.
SOLUTION
We added sirolimus, a macrolide antibiotic, with properties of T- and B-lymphocyte proliferation inhibition on the above immunosuppressive treatment postrecurrence of GCM. After sirolimus initiation and continuation, the patient has remained disease free.
DOI: 10.1097/MJT.0000000000000796
PubMed: 29889677
Affiliations:
Links toward previous steps (curation, corpus...)
Le document en format XML
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uniqKey="Zolty R" first="Ronald" last="Zolty">Ronald Zolty</name><affiliation wicri:level="2"><nlm:affiliation>Department of Cardiovascular Medicine, University of Nebraska Medical Center, Omaha, NE.</nlm:affiliation><country xml:lang="fr">États-Unis</country><placeName><region type="state">Nebraska</region></placeName><wicri:cityArea>Department of Cardiovascular Medicine, University of Nebraska Medical Center, Omaha</wicri:cityArea></affiliation></author></analytic><series><title level="j">American journal of therapeutics</title><idno type="eISSN">1536-3686</idno></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Allografts (cytology)</term><term>Allografts (diagnostic imaging)</term><term>Allografts (immunology)</term><term>Drug Therapy, Combination (methods)</term><term>Echocardiography (MeSH)</term><term>Giant Cells (immunology)</term><term>Graft Rejection (diagnosis)</term><term>Graft Rejection (drug therapy)</term><term>Graft Rejection (immunology)</term><term>Heart (diagnostic imaging)</term><term>Heart Transplantation (adverse effects)</term><term>Humans (MeSH)</term><term>Immunosuppressive Agents (therapeutic use)</term><term>Magnetic Resonance Imaging (MeSH)</term><term>Male (MeSH)</term><term>Middle Aged (MeSH)</term><term>Myocarditis (diagnosis)</term><term>Myocarditis (therapy)</term><term>Myocardium (cytology)</term><term>Myocardium (immunology)</term><term>Recurrence (MeSH)</term><term>Sirolimus (therapeutic use)</term><term>Treatment Outcome (MeSH)</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Adulte d'âge moyen (MeSH)</term><term>Allogreffes (cytologie)</term><term>Allogreffes (imagerie diagnostique)</term><term>Allogreffes (immunologie)</term><term>Association de médicaments (méthodes)</term><term>Cellules géantes (immunologie)</term><term>Coeur (imagerie diagnostique)</term><term>Humains (MeSH)</term><term>Imagerie par résonance magnétique (MeSH)</term><term>Immunosuppresseurs (usage thérapeutique)</term><term>Myocarde (cytologie)</term><term>Myocarde (immunologie)</term><term>Myocardite (diagnostic)</term><term>Myocardite (thérapie)</term><term>Mâle (MeSH)</term><term>Rejet du greffon (diagnostic)</term><term>Rejet du greffon (immunologie)</term><term>Rejet du greffon (traitement médicamenteux)</term><term>Récidive (MeSH)</term><term>Résultat thérapeutique (MeSH)</term><term>Sirolimus (usage thérapeutique)</term><term>Transplantation cardiaque (effets indésirables)</term><term>Échocardiographie (MeSH)</term></keywords><keywords scheme="MESH" type="chemical" qualifier="therapeutic use" xml:lang="en"><term>Immunosuppressive Agents</term><term>Sirolimus</term></keywords><keywords scheme="MESH" qualifier="adverse effects" xml:lang="en"><term>Heart Transplantation</term></keywords><keywords scheme="MESH" qualifier="cytologie" xml:lang="fr"><term>Allogreffes</term><term>Myocarde</term></keywords><keywords scheme="MESH" qualifier="cytology" xml:lang="en"><term>Allografts</term><term>Myocardium</term></keywords><keywords scheme="MESH" qualifier="diagnosis" xml:lang="en"><term>Graft Rejection</term><term>Myocarditis</term></keywords><keywords scheme="MESH" qualifier="diagnostic" xml:lang="fr"><term>Myocardite</term><term>Rejet du greffon</term></keywords><keywords scheme="MESH" qualifier="diagnostic imaging" xml:lang="en"><term>Allografts</term><term>Heart</term></keywords><keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>Graft Rejection</term></keywords><keywords scheme="MESH" qualifier="effets indésirables" xml:lang="fr"><term>Transplantation cardiaque</term></keywords><keywords scheme="MESH" qualifier="imagerie diagnostique" xml:lang="fr"><term>Allogreffes</term><term>Coeur</term></keywords><keywords scheme="MESH" qualifier="immunologie" xml:lang="fr"><term>Allogreffes</term><term>Cellules géantes</term><term>Myocarde</term><term>Rejet du greffon</term></keywords><keywords scheme="MESH" qualifier="immunology" xml:lang="en"><term>Allografts</term><term>Giant Cells</term><term>Graft Rejection</term><term>Myocardium</term></keywords><keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Drug Therapy, Combination</term></keywords><keywords scheme="MESH" qualifier="méthodes" xml:lang="fr"><term>Association de médicaments</term></keywords><keywords scheme="MESH" qualifier="therapy" xml:lang="en"><term>Myocarditis</term></keywords><keywords scheme="MESH" qualifier="thérapie" xml:lang="fr"><term>Myocardite</term></keywords><keywords scheme="MESH" qualifier="traitement médicamenteux" xml:lang="fr"><term>Rejet du greffon</term></keywords><keywords scheme="MESH" qualifier="usage thérapeutique" xml:lang="fr"><term>Immunosuppresseurs</term><term>Sirolimus</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Echocardiography</term><term>Humans</term><term>Magnetic Resonance Imaging</term><term>Male</term><term>Middle Aged</term><term>Recurrence</term><term>Treatment Outcome</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Adulte d'âge moyen</term><term>Humains</term><term>Imagerie par résonance magnétique</term><term>Mâle</term><term>Récidive</term><term>Résultat thérapeutique</term><term>Échocardiographie</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><b>CLINICAL FEATURES</b></p><p>Giant cell myocarditis (GCM) is a rare and a rapidly progressive disorder with fatal outcomes such that patients often require heart transplantation. We present a case of recurrent GCM in a transplanted patient with a history of Crohn disease requiring a novel therapeutic approach.</p></div><div type="abstract" xml:lang="en"><p><b>THERAPEUTIC CHALLENGE</b></p><p>After the orthotopic heart transplantation, GCM recurred on aggressive immunosuppression over the months, which included corticosteroids, basiliximab, tacrolimus, antithymocyte globulin, and rituximab. Although combination immunosuppressive therapy containing cyclosporine and 2-4 additional drugs including corticosteroids, azathioprine, mycophenolate mofetil, muromonab, gammaglobulin, or methotrexate have shown to prolong the transplant-free survival by keeping the disease under control, its role in preventing and treating recurrence posttransplantation is unclear.</p></div><div type="abstract" xml:lang="en"><p><b>SOLUTION</b></p><p>We added sirolimus, a macrolide antibiotic, with properties of T- and B-lymphocyte proliferation inhibition on the above immunosuppressive treatment postrecurrence of GCM. After sirolimus initiation and continuation, the patient has remained disease free.</p></div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">29889677</PMID><DateCompleted><Year>2020</Year><Month>02</Month><Day>05</Day></DateCompleted><DateRevised><Year>2020</Year><Month>02</Month><Day>05</Day></DateRevised><Article PubModel="Print"><Journal><ISSN IssnType="Electronic">1536-3686</ISSN><JournalIssue CitedMedium="Internet"><Volume>26</Volume><Issue>5</Issue><PubDate><MedlineDate>2019 Sep/Oct</MedlineDate></PubDate></JournalIssue><Title>American journal of therapeutics</Title><ISOAbbreviation>Am J Ther</ISOAbbreviation></Journal><ArticleTitle>Sirolimus for Recurrent Giant Cell Myocarditis After Heart Transplantation: A Unique Therapeutic Strategy.</ArticleTitle><Pagination><MedlinePgn>600-603</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1097/MJT.0000000000000796</ELocationID><Abstract><AbstractText Label="CLINICAL FEATURES" NlmCategory="METHODS">Giant cell myocarditis (GCM) is a rare and a rapidly progressive disorder with fatal outcomes such that patients often require heart transplantation. We present a case of recurrent GCM in a transplanted patient with a history of Crohn disease requiring a novel therapeutic approach.</AbstractText><AbstractText Label="THERAPEUTIC CHALLENGE" NlmCategory="UNASSIGNED">After the orthotopic heart transplantation, GCM recurred on aggressive immunosuppression over the months, which included corticosteroids, basiliximab, tacrolimus, antithymocyte globulin, and rituximab. Although combination immunosuppressive therapy containing cyclosporine and 2-4 additional drugs including corticosteroids, azathioprine, mycophenolate mofetil, muromonab, gammaglobulin, or methotrexate have shown to prolong the transplant-free survival by keeping the disease under control, its role in preventing and treating recurrence posttransplantation is unclear.</AbstractText><AbstractText Label="SOLUTION" NlmCategory="METHODS">We added sirolimus, a macrolide antibiotic, with properties of T- and B-lymphocyte proliferation inhibition on the above immunosuppressive treatment postrecurrence of GCM. After sirolimus initiation and continuation, the patient has remained disease free.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Patel</LastName><ForeName>Apurva D</ForeName><Initials>AD</Initials><AffiliationInfo><Affiliation>Department of Cardiovascular Medicine, University of Nebraska Medical Center, Omaha, NE.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Lowes</LastName><ForeName>Brian</ForeName><Initials>B</Initials><AffiliationInfo><Affiliation>Department of Cardiovascular Medicine, University of Nebraska Medical Center, Omaha, NE.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Chamsi-Pasha</LastName><ForeName>Mohammed A</ForeName><Initials>MA</Initials><AffiliationInfo><Affiliation>Department of Cardiovascular Medicine, University of Nebraska Medical Center, Omaha, NE.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Department of Cardiology, Cardiovascular Imaging Institute, The Methodist DeBakey Heart and Vascular Center, Houston, TX.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Radio</LastName><ForeName>Stanley J</ForeName><Initials>SJ</Initials><AffiliationInfo><Affiliation>Department of Pathology and Microbiology, University of Nebraska Medical Center, Omaha, NE.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Hyden</LastName><ForeName>Marshall</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Department of Cardiovascular Medicine, University of Nebraska Medical Center, Omaha, NE.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Zolty</LastName><ForeName>Ronald</ForeName><Initials>R</Initials><AffiliationInfo><Affiliation>Department of Cardiovascular Medicine, University of Nebraska Medical Center, Omaha, NE.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D002363">Case Reports</PublicationType><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList></Article><MedlineJournalInfo><Country>United States</Country><MedlineTA>Am J Ther</MedlineTA><NlmUniqueID>9441347</NlmUniqueID><ISSNLinking>1075-2765</ISSNLinking></MedlineJournalInfo><ChemicalList><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D007166">Immunosuppressive Agents</NameOfSubstance></Chemical><Chemical><RegistryNumber>W36ZG6FT64</RegistryNumber><NameOfSubstance UI="D020123">Sirolimus</NameOfSubstance></Chemical></ChemicalList><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D064591" MajorTopicYN="N">Allografts</DescriptorName><QualifierName UI="Q000166" MajorTopicYN="N">cytology</QualifierName><QualifierName UI="Q000000981" MajorTopicYN="N">diagnostic imaging</QualifierName><QualifierName UI="Q000276" MajorTopicYN="N">immunology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D004359" MajorTopicYN="N">Drug Therapy, Combination</DescriptorName><QualifierName UI="Q000379" MajorTopicYN="N">methods</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D004452" MajorTopicYN="N">Echocardiography</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D015726" MajorTopicYN="N">Giant Cells</DescriptorName><QualifierName UI="Q000276" MajorTopicYN="N">immunology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D006084" MajorTopicYN="N">Graft Rejection</DescriptorName><QualifierName UI="Q000175" MajorTopicYN="N">diagnosis</QualifierName><QualifierName UI="Q000188" MajorTopicYN="Y">drug therapy</QualifierName><QualifierName UI="Q000276" MajorTopicYN="N">immunology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D006321" MajorTopicYN="N">Heart</DescriptorName><QualifierName UI="Q000000981" MajorTopicYN="N">diagnostic imaging</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D016027" MajorTopicYN="N">Heart Transplantation</DescriptorName><QualifierName UI="Q000009" MajorTopicYN="Y">adverse effects</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D007166" MajorTopicYN="N">Immunosuppressive Agents</DescriptorName><QualifierName UI="Q000627" MajorTopicYN="Y">therapeutic use</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D008279" MajorTopicYN="N">Magnetic Resonance Imaging</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008875" MajorTopicYN="N">Middle Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D009205" MajorTopicYN="N">Myocarditis</DescriptorName><QualifierName UI="Q000175" MajorTopicYN="N">diagnosis</QualifierName><QualifierName UI="Q000628" MajorTopicYN="Y">therapy</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D009206" MajorTopicYN="N">Myocardium</DescriptorName><QualifierName UI="Q000166" MajorTopicYN="N">cytology</QualifierName><QualifierName UI="Q000276" MajorTopicYN="N">immunology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D012008" MajorTopicYN="N">Recurrence</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D020123" MajorTopicYN="N">Sirolimus</DescriptorName><QualifierName UI="Q000627" MajorTopicYN="Y">therapeutic use</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D016896" MajorTopicYN="N">Treatment Outcome</DescriptorName></MeshHeading></MeshHeadingList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="pubmed"><Year>2018</Year><Month>6</Month><Day>12</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2020</Year><Month>2</Month><Day>6</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2018</Year><Month>6</Month><Day>12</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">29889677</ArticleId><ArticleId IdType="doi">10.1097/MJT.0000000000000796</ArticleId></ArticleIdList></PubmedData></pubmed><affiliations><list><country><li>États-Unis</li></country><region><li>Nebraska</li><li>Texas</li></region></list><tree><country name="États-Unis"><region name="Nebraska"><name sortKey="Patel, Apurva D" sort="Patel, Apurva D" uniqKey="Patel A" first="Apurva D" last="Patel">Apurva D. Patel</name></region><name sortKey="Chamsi Pasha, Mohammed A" sort="Chamsi Pasha, Mohammed A" uniqKey="Chamsi Pasha M" first="Mohammed A" last="Chamsi-Pasha">Mohammed A. Chamsi-Pasha</name><name sortKey="Chamsi Pasha, Mohammed A" sort="Chamsi Pasha, Mohammed A" uniqKey="Chamsi Pasha M" first="Mohammed A" last="Chamsi-Pasha">Mohammed A. Chamsi-Pasha</name><name sortKey="Hyden, Marshall" sort="Hyden, Marshall" uniqKey="Hyden M" first="Marshall" last="Hyden">Marshall Hyden</name><name sortKey="Lowes, Brian" sort="Lowes, Brian" uniqKey="Lowes B" first="Brian" last="Lowes">Brian Lowes</name><name sortKey="Radio, Stanley J" sort="Radio, Stanley J" uniqKey="Radio S" first="Stanley J" last="Radio">Stanley J. Radio</name><name sortKey="Zolty, Ronald" sort="Zolty, Ronald" uniqKey="Zolty R" first="Ronald" last="Zolty">Ronald Zolty</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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