Recurrent autoimmune myocarditis in a young woman during the coronavirus disease 2019 pandemic

We report a unique case of a young woman with recurrent immune ‐mediated (virus‐negative) lymphocytic fulminant myocarditis during the coronavirus disease 2019 pandemic. At the first endomyocardial biopsy (EMB)‐proven episode, she had concomitant pneumonia, and a temporary biventricular assist device implant was followed by complete and long‐lasting car diac recovery. Five years later, she was re‐admitted for relapsing cardiogenic shock with a recent history of pneumonia. She was treated with extracorporeal life support with apical venting for left ventricular unloading, and full recovery was achieved. Despite negative seriate nasopharyngeal swab s and EMB during hospitalization, an antibody positivity for severe acute respiratory syndrome coronavirus 2 was discovered after 4 weeks from discharge. This is the first report of an EMB‐proven, immune‐mediated (virus‐negative) recurrence of fulminant myocarditis. We hypothesize that in pat ients with a predisposing immunogenetic background, autoimmune disease may be triggered or reactivated by major infections, for example, pneumonia, that may act as adjuvants leading to an immune‐mediated hyper‐response.

Source: ESC Heart Failure - November 22, 2020 Category: Cardiology Authors: Raphael Caraffa, Renzo Marcolongo, Tomaso Bottio, Stefania Riza, Olimpia Bifulco, Lorenzo Bagozzi, Augusto D'Onofrio, Alida L.P. Caforio, Vjola Jorgji, Cristina Basso, Gino Gerosa Tags: Case Report Source Type: research