PMID- 31632937
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20201001
IS  - 2296-2360 (Print)
IS  - 2296-2360 (Electronic)
IS  - 2296-2360 (Linking)
VI  - 7
DP  - 2019
TI  - The Clinical Features of Children With Acute Fulminant Myocarditis and the 
      Diagnostic and Follow-Up Value of Cardiovascular Magnetic Resonance.
PG  - 388
LID - 10.3389/fped.2019.00388 [doi]
LID - 388
AB  - Objective: To investigate the clinical features and the diagnostic and follow-up 
      value of acute fulminant myocarditis (AFM) in children. Methods: A total of 20 
      children diagnosed with AFM admitted to our department were reviewed, and the 
      clinical manifestations; pathogenic examination results; myocardial injury 
      biomarkers; and electrocardiography, echocardiogram, and cardiovascular magnetic 
      resonance (CMR) results were analyzed. Results: Twenty children with AFM, 
      including 12 males and 8 females, aged 3-16 years, were analyzed. The initial 
      symptoms were abdominal pain, vomiting, fatigue, syncope, and convulsions. All 
      children had significantly increased hs-cTnT and NT-pro BNP. In addition to 
      nonspecific ST-T changes, there were 10 cases of complete atrioventricular block, 
      2 cases of advanced atrioventricular block, and 1 case of ventricular 
      tachycardia. Echocardiography showed an increase in the cardiac chamber sizes in 
      15 patients and a decrease in left ventricular ejection fraction (LVEF) in 17 
      patients. There were 16 patients with abnormal CMR findings, including 13 cases 
      of high T2-weighted image (T2WI) signal and 14 cases of late gadolinium 
      enhancement (LGE). In the patients who underwent CMR within 14 days of onset, the 
      sensitivity of T2WI and LGE and the positive diagnosis rate were higher than in 
      those who underwent CMR after 14 days, but the difference was not statistically 
      significant. CMR was followed up in 10 patients: 7 patients returned to normal, 2 
      patients still had mild LGE, and 1 patient developed inflammatory dilated 
      cardiomyopathy. All patients were treated with high-dose immunoglobulin, 11 of 
      whom received high-dose immunoglobulin combined with glucocorticoids. Eight 
      patients received temporary pacemakers, and 1 patient received ECMO. None of the 
      patients died. The peak of hs-cTnT was significantly higher in the glucocorticoid 
      group than in the unused glucocorticoid group (2853.4 +/- 2217.2 and 1124.7 +/- 527.3 
      pg/ml, respectively). Conclusion: Children with AFM have unique clinical 
      features. Early identification and effective treatment can reduce the mortality 
      rate and improve the prognosis. CMR is highly sensitive in the diagnosis of ARM, 
      especially within 14 days of onset, and is a useful noninvasive imaging technique 
      for the early identification of AFM in children. The dynamic observation and 
      follow-up of children with AFM through CMR can guide clinical decision-making and 
      prognosis assessment.
CI  - Copyright (c) 2019 Lv, Han, Wang, Wang, Jiang, Zhao, Yi and Zhang.
FAU - Lv, Jianli
AU  - Lv J
AD  - Department of Pediatric Cardiology, Shandong Provincial Hospital Affiliated to 
      Shandong University, Jinan, China.
FAU - Han, Bo
AU  - Han B
AD  - Department of Pediatric Cardiology, Shandong Provincial Hospital Affiliated to 
      Shandong University, Jinan, China.
FAU - Wang, Cuiyan
AU  - Wang C
AD  - Shandong Medical Imaging Research Institute, Jinan, China.
FAU - Wang, Jing
AU  - Wang J
AD  - Department of Pediatric Cardiology, Shandong Provincial Hospital Affiliated to 
      Shandong University, Jinan, China.
FAU - Jiang, Diandong
AU  - Jiang D
AD  - Department of Pediatric Cardiology, Shandong Provincial Hospital Affiliated to 
      Shandong University, Jinan, China.
FAU - Zhao, Lijian
AU  - Zhao L
AD  - Department of Pediatric Cardiology, Shandong Provincial Hospital Affiliated to 
      Shandong University, Jinan, China.
FAU - Yi, Yingchun
AU  - Yi Y
AD  - Department of Pediatric Cardiology, Shandong Provincial Hospital Affiliated to 
      Shandong University, Jinan, China.
FAU - Zhang, Jianjun
AU  - Zhang J
AD  - Department of Pediatric Cardiology, Shandong Provincial Hospital Affiliated to 
      Shandong University, Jinan, China.
LA  - eng
PT  - Journal Article
DEP - 20191001
PL  - Switzerland
TA  - Front Pediatr
JT  - Frontiers in pediatrics
JID - 101615492
PMC - PMC6779687
OTO - NOTNLM
OT  - ECMO
OT  - acute fulminant myocarditis
OT  - cardiovascular magnetic resonance
OT  - children
OT  - pacemaker
EDAT- 2019/10/22 06:00
MHDA- 2019/10/22 06:01
PMCR- 2019/10/01
CRDT- 2019/10/22 06:00
PHST- 2019/06/26 00:00 [received]
PHST- 2019/09/09 00:00 [accepted]
PHST- 2019/10/22 06:00 [entrez]
PHST- 2019/10/22 06:00 [pubmed]
PHST- 2019/10/22 06:01 [medline]
PHST- 2019/10/01 00:00 [pmc-release]
AID - 10.3389/fped.2019.00388 [doi]
PST - epublish
SO  - Front Pediatr. 2019 Oct 1;7:388. doi: 10.3389/fped.2019.00388. eCollection 2019.