Combined use of intravenous immune globulin and steroid for acute myocarditis in pediatric population

ABSTRACT

The optimum treatment for acute viral myocarditis in pediatric population is unknown. Some studies have shown the beneficial effect of high dose intravenous immunoglobulin [IVIG] while other reports suggested the corticosteroid to be effective in the treatment of acute viral myocarditis. In this study, we present our experience with combined use of high dose IVIG and corticosteroid along with conventional antifailure treatment for clinical acute viral mypcarditis in pediatric population. Thirteen patients were included in the study with the clinical diagnosis of acute viral myocardistis and reduced cardiac function ie fractional shortening of < 28%. In the study group, 53% were male and 46% female with median age of 12 months and were treated with high dose IVIG and corticosteroid. Left ventricular function, left ventricular end diastolic dimension [LVEDD] and degree of mitral regurgitation [MR] were assessed echocardiographically at presentation; at 6 weeks and then at 6 months follow-up. At 6 months follow-up, LV function normalized in 92% of the patients, LVEDD improved in 62% and 84.6% of the patients had insignificant MR. Our data suggest that use of high dose IVIG in combination with corticosteroid is an effective treatment for acute viral myocarditis in pediatric population