TITLE:
Effect of intravenous gamma globulin on short- and mid-term clinical outcome in acute viral myocarditis in children
AUTHORS:
Mehnaz Atiq, Mehar Hoda, Nadeem Aslam
KEYWORDS:
Acute Myocarditis; Intravenous Gamma Globulins; Congestive Heart failure
JOURNAL NAME:
World Journal of Cardiovascular Diseases,
Vol.4 No.2,
February
12,
2014
ABSTRACT: Acute
viral myocarditis is an extremely diverse disease with a predictable good
outcome with supportive therapy. The objective of this study was to look at the clinical outcome of patients receiving
additional intravenous gamma globulin compared to those receiving
conventional anti-congestive therapy alone. Patients and methods: This is a
retrospective review of charts of children admitted with acute myocarditis.
Group 1 was children who received intravenous gamma globulin (IVIG) along with
conventional anti-congestive therapy. Group 2 were patients who received the conventional anticongestive therapy alone. Short-term
outcome was survival to hospital discharge, and mid-term outcome was
improvement of left ventricular ejection fraction at 6 months and one year follow-up. Results: A total of 36 patients were enrolled and 18 were males. The mean age of all patients was 2.3 ± 2.6 years
and the mean duration of illness for the whole group was 6.7 ± 3.8 days. Group
1 comprised of 16 patients. There was no difference in short-term outcome with
mortality of 2 patients in Group1 (12.5%) and 3(15%) in Group 2 (p = 0.2). At
intermediate term follow up, recovery of ejection fraction in Group 1 was in
4/14 (28%) and in Group 2 it was 9/17 (55%) and at 12 months it was 10/13 (77%)
in Group 1 and 15/16 (94%) in Group 2 (p = 0.02 and 0.19 respectively). Conclusion:
Acute myocarditis has a high spontaneous cure rate. Our study did not show any
significant difference in the short-term or midterm outcome between children
receiving IVIG compared to those who did not.