Fulminant myocarditis demonstrating uncommon morphology: a report of two autopsy cases
Two autopsy cases of fulminant myocarditis demonstrating uncommon morphology were studied. Subjects included two male patients: a 42-year-old (case 1) and a 39-year-old (case 2). Both cases had fever, chest or epigastric pain, electrocardiographic abnormalities, prominent elevation of serum glutamic...
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| Veröffentlicht in: | Virchows Archiv : an international journal of pathology 2005-03, Vol.446 (3), p.259-264 |
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| creator | OKA, Kuniyuki OOHIRA, Koji YATABE, Yasushi TANAKA, Toshio KURANO, Kozo KOSUGI, Rie MURATA, Minoru HAKOZAKI, Hando NISHIKAWA, Toshio TSUTSUMI, Yutaka |
| description | Two autopsy cases of fulminant myocarditis demonstrating uncommon morphology were studied. Subjects included two male patients: a 42-year-old (case 1) and a 39-year-old (case 2). Both cases had fever, chest or epigastric pain, electrocardiographic abnormalities, prominent elevation of serum glutamic oxaloacetic transaminase, glutamic pyruvic transaminase, lactic dehydrogenase and creatine phosphokinase. They were treated with intra-aortic balloon pumping and percutaneous cardiopulmonary support, and they died at 3 days and 4 days after admission (total course of 10 days and 9 days), respectively. Case 1 showed focal necrosis, severe myocardial dystrophic calcification positive for Kossa stain, inflammatory edema, lymphocyte and macrophage infiltration and extravasation of erythrocytes. Case 2 showed acute inflammation and severe myocardial necrosis with neutrophilic abscess, lymphocyte and macrophage infiltration, cell debris and purulent exudate. Calcified, degenerative and necrotic cardiac myocytes and macrophages were reacted with anti-Enterovirus antibody (clone 5-D8/1), which recognizes an epitope on the VP1 peptide of most Coxsackievirus, echovirus, poliovirus and enterovirus strains. Therefore, the present two cases may be compatible with fulminant enterovirus-associated myocarditis. Using reverse transcriptase-semi-nested polymerase chain reaction, picornaviral RNA was detected in the amplified products extracted from the paraffin-embedded myocardial sample of case 1 but not in case 2. |
| doi_str_mv | 10.1007/s00428-004-1173-3 |
| format | Article |
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Subjects included two male patients: a 42-year-old (case 1) and a 39-year-old (case 2). Both cases had fever, chest or epigastric pain, electrocardiographic abnormalities, prominent elevation of serum glutamic oxaloacetic transaminase, glutamic pyruvic transaminase, lactic dehydrogenase and creatine phosphokinase. They were treated with intra-aortic balloon pumping and percutaneous cardiopulmonary support, and they died at 3 days and 4 days after admission (total course of 10 days and 9 days), respectively. Case 1 showed focal necrosis, severe myocardial dystrophic calcification positive for Kossa stain, inflammatory edema, lymphocyte and macrophage infiltration and extravasation of erythrocytes. Case 2 showed acute inflammation and severe myocardial necrosis with neutrophilic abscess, lymphocyte and macrophage infiltration, cell debris and purulent exudate. Calcified, degenerative and necrotic cardiac myocytes and macrophages were reacted with anti-Enterovirus antibody (clone 5-D8/1), which recognizes an epitope on the VP1 peptide of most Coxsackievirus, echovirus, poliovirus and enterovirus strains. Therefore, the present two cases may be compatible with fulminant enterovirus-associated myocarditis. Using reverse transcriptase-semi-nested polymerase chain reaction, picornaviral RNA was detected in the amplified products extracted from the paraffin-embedded myocardial sample of case 1 but not in case 2.</description><identifier>ISSN: 0945-6317</identifier><identifier>EISSN: 1432-2307</identifier><identifier>DOI: 10.1007/s00428-004-1173-3</identifier><identifier>PMID: 15668804</identifier><language>eng</language><publisher>Berlin: Springer</publisher><subject>Adult ; Animals ; Autopsy ; Biological and medical sciences ; Calcinosis - pathology ; Calcinosis - physiopathology ; Calcinosis - virology ; Capsid Proteins - genetics ; Cardiology. Vascular system ; Edema ; Heart ; Humans ; Immunohistochemistry ; Infiltration ; Investigative techniques, diagnostic techniques (general aspects) ; Lymphocytes ; Male ; Medical sciences ; Myocarditis - pathology ; Myocarditis - physiopathology ; Myocarditis - virology ; Myocarditis. Cardiomyopathies ; Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques ; Picornaviridae - genetics ; Picornaviridae Infections - complications ; Picornaviridae Infections - pathology ; Picornaviridae Infections - physiopathology ; Reverse Transcriptase Polymerase Chain Reaction ; RNA, Viral</subject><ispartof>Virchows Archiv : an international journal of pathology, 2005-03, Vol.446 (3), p.259-264</ispartof><rights>2005 INIST-CNRS</rights><rights>Springer-Verlag 2005</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c422t-5db6a1048f4b578fdbf5e85a8f15247df482550e5c539f6abd8bbe10ec68a1d53</citedby><cites>FETCH-LOGICAL-c422t-5db6a1048f4b578fdbf5e85a8f15247df482550e5c539f6abd8bbe10ec68a1d53</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=16661501$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/15668804$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>OKA, Kuniyuki</creatorcontrib><creatorcontrib>OOHIRA, Koji</creatorcontrib><creatorcontrib>YATABE, Yasushi</creatorcontrib><creatorcontrib>TANAKA, Toshio</creatorcontrib><creatorcontrib>KURANO, Kozo</creatorcontrib><creatorcontrib>KOSUGI, Rie</creatorcontrib><creatorcontrib>MURATA, Minoru</creatorcontrib><creatorcontrib>HAKOZAKI, Hando</creatorcontrib><creatorcontrib>NISHIKAWA, Toshio</creatorcontrib><creatorcontrib>TSUTSUMI, Yutaka</creatorcontrib><title>Fulminant myocarditis demonstrating uncommon morphology: a report of two autopsy cases</title><title>Virchows Archiv : an international journal of pathology</title><addtitle>Virchows Arch</addtitle><description>Two autopsy cases of fulminant myocarditis demonstrating uncommon morphology were studied. Subjects included two male patients: a 42-year-old (case 1) and a 39-year-old (case 2). Both cases had fever, chest or epigastric pain, electrocardiographic abnormalities, prominent elevation of serum glutamic oxaloacetic transaminase, glutamic pyruvic transaminase, lactic dehydrogenase and creatine phosphokinase. They were treated with intra-aortic balloon pumping and percutaneous cardiopulmonary support, and they died at 3 days and 4 days after admission (total course of 10 days and 9 days), respectively. Case 1 showed focal necrosis, severe myocardial dystrophic calcification positive for Kossa stain, inflammatory edema, lymphocyte and macrophage infiltration and extravasation of erythrocytes. Case 2 showed acute inflammation and severe myocardial necrosis with neutrophilic abscess, lymphocyte and macrophage infiltration, cell debris and purulent exudate. Calcified, degenerative and necrotic cardiac myocytes and macrophages were reacted with anti-Enterovirus antibody (clone 5-D8/1), which recognizes an epitope on the VP1 peptide of most Coxsackievirus, echovirus, poliovirus and enterovirus strains. Therefore, the present two cases may be compatible with fulminant enterovirus-associated myocarditis. Using reverse transcriptase-semi-nested polymerase chain reaction, picornaviral RNA was detected in the amplified products extracted from the paraffin-embedded myocardial sample of case 1 but not in case 2.</description><subject>Adult</subject><subject>Animals</subject><subject>Autopsy</subject><subject>Biological and medical sciences</subject><subject>Calcinosis - pathology</subject><subject>Calcinosis - physiopathology</subject><subject>Calcinosis - virology</subject><subject>Capsid Proteins - genetics</subject><subject>Cardiology. Vascular system</subject><subject>Edema</subject><subject>Heart</subject><subject>Humans</subject><subject>Immunohistochemistry</subject><subject>Infiltration</subject><subject>Investigative techniques, diagnostic techniques (general aspects)</subject><subject>Lymphocytes</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Myocarditis - pathology</subject><subject>Myocarditis - physiopathology</subject><subject>Myocarditis - virology</subject><subject>Myocarditis. Cardiomyopathies</subject><subject>Pathology. Cytology. Biochemistry. Spectrometry. 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Subjects included two male patients: a 42-year-old (case 1) and a 39-year-old (case 2). Both cases had fever, chest or epigastric pain, electrocardiographic abnormalities, prominent elevation of serum glutamic oxaloacetic transaminase, glutamic pyruvic transaminase, lactic dehydrogenase and creatine phosphokinase. They were treated with intra-aortic balloon pumping and percutaneous cardiopulmonary support, and they died at 3 days and 4 days after admission (total course of 10 days and 9 days), respectively. Case 1 showed focal necrosis, severe myocardial dystrophic calcification positive for Kossa stain, inflammatory edema, lymphocyte and macrophage infiltration and extravasation of erythrocytes. Case 2 showed acute inflammation and severe myocardial necrosis with neutrophilic abscess, lymphocyte and macrophage infiltration, cell debris and purulent exudate. Calcified, degenerative and necrotic cardiac myocytes and macrophages were reacted with anti-Enterovirus antibody (clone 5-D8/1), which recognizes an epitope on the VP1 peptide of most Coxsackievirus, echovirus, poliovirus and enterovirus strains. Therefore, the present two cases may be compatible with fulminant enterovirus-associated myocarditis. Using reverse transcriptase-semi-nested polymerase chain reaction, picornaviral RNA was detected in the amplified products extracted from the paraffin-embedded myocardial sample of case 1 but not in case 2.</abstract><cop>Berlin</cop><pub>Springer</pub><pmid>15668804</pmid><doi>10.1007/s00428-004-1173-3</doi><tpages>6</tpages></addata></record> |
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| subjects | Adult Animals Autopsy Biological and medical sciences Calcinosis - pathology Calcinosis - physiopathology Calcinosis - virology Capsid Proteins - genetics Cardiology. Vascular system Edema Heart Humans Immunohistochemistry Infiltration Investigative techniques, diagnostic techniques (general aspects) Lymphocytes Male Medical sciences Myocarditis - pathology Myocarditis - physiopathology Myocarditis - virology Myocarditis. Cardiomyopathies Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques Picornaviridae - genetics Picornaviridae Infections - complications Picornaviridae Infections - pathology Picornaviridae Infections - physiopathology Reverse Transcriptase Polymerase Chain Reaction RNA, Viral |
| title | Fulminant myocarditis demonstrating uncommon morphology: a report of two autopsy cases |
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