Barış AKDUMAN, Dilhan TÜRKKAN, Mustafa KARAPİRLİ, Hanife ALKAN-ALKURT, Doğuş ÖZDEMİR-KARA, Sultan PEHLİVAN

Idiopathic giant cell myocarditis in a newborn: case report

Özdemir-Kara D, Pehlivan S, Türkkan D, Alkan-Alkurt H, Akduman B,Karapirli M. Idiopathic giant cell myocarditis in a newborn. Turk J Pediatr2016; 58: 429-431.Idiopathic giant cell myocarditis (IGCM) is a rare cause of arrhythmia, heartfailure and death in children. The etiology of IGCM is unknown. Endomyocardialbiopsy and histological examination are essential for diagnosis. In our case,a one-month-old baby boy with no prior medical history died during breastfeeding.The gross autopsy and drug screen failed to disclose a cause of death.Hemotoxylen Eosin (H&E) stained cardiac tissue slides showed widespreadand multifocal necrosis accompanied by mixed inflammatory infiltrate. Admixedwith the infiltrate were fibroblastic proliferation and multinucleated giant cellsin the absence of sarcoid like granuloma. Although myocarditis is usuallythought to be a disease of older children, infants can also be affected. Thisentity can be the cause of some cases of sudden unexpected death in infancy.

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1. Magnani JW, Dec GW. Myocarditis: current trends in diagnosis and treatment. Circulation 2006; 113:876- 890.
2. Aretz HT, Billingham ME, Edwards WD, et al. Myocarditis: a histologic definition and classification. Am J Cardiovasc Pathol 1986; 1: 3-14.
3. Kodama M, Zhang S, Hanawa H, Shibata A. Immunohistochemical characterization of infiltrating mononuclear cells in the rat heart with experimental autoimmune giant cell myocarditis. Clin Exp Immunol 1992; 90: 330-335.
4. Cooper LT Jr, Berry GJ, Shabetai R. Idiopathic giant-cell myocarditis-natural history and treatment. Multicenter Giant Cell Myocarditis Study Group Investigators. N Engl J Med 1997; 336: 1860-1866.
5. Billingham M. Acute myocarditis: a diagnostic dilemma. Br Heart J 1987; 58: 6-8.
6. Berry GJ, Atkins KA. Pathology of Human Myocarditis. Myocarditis, From Bench to Bedside. Totowa, NJ: Humana press, 2003; 14: 325-371.
7. Ilina MV, Kepron CA, Taylor GP, Perrin DG, Kanto PF, Somers GR. Undiagnosed heart disease leading to sudden unexpected death in childhood: a retrospective study. Pediatrics 2011; 128: e513-e520.
8. Davies MJ, Pomerance A, Teare RD. Idiopathic giant cell myocarditis-a distinctive clinicopathological entity. Br Heart J 1975; 37: 192-195.
9. Cooper LT. Giant cell myocarditis in children. Prog Pediatr Cardiol 2007; 24: 47-49.
10. Cunningham KS, Veinot JP, Butany J. An approach to endomyocardial biopsy interpretation. J Clin Pathol 2006; 59: 121-129.
11. Akça Kaya E, Pakiş I, Özbay M, Büyük Y, Küçük C. Dev hücreli miyokardite bağlı ani ölüm. Acıbadem Üniversitesi Sağlık Bilimleri Dergisi 2010; 1: 235-237.
12. de Vetten L, Bergman KA, Elzenga NJ, van Melle JP, Timmer A, Bartelds B. Neonatal myocardial infarction or myocarditis?. Pediatr Cardiol 2011; 32: 492-497.
13. Cooper LT. Idiopathic Giant Cell Myocarditis. In: Cooper LT (ed). Myocarditis From Bench to Bedside (2nd ed). Vol. 17. New Jersey: Humana press, 2003: 405-420.
14. Hauck AJ, Kearney DL, Edwards WD. Evaluation of postmortem endomyocardial biopsy specimens from 38 patients with lymphocytic myocarditis: implications for role of sampling error. Mayo Clin Proc 1989; 64: 1235-1245.