Idiopathic giant cell myocarditis - A case report and review of literature

Department of Pathology, Al Ameen Medical College, Bijapur, Karnataka.
Indian Journal of Pathology and Microbiology (Impact Factor: 0.47). 05/2003; 46(2):241-3.
Source: PubMed


Idiopathic giant cell myocarditis (IGCM) is a rare clinicopathological entity which is usually known to cause in more than half the cases sudden death. The histological features are characteristic with a central area of myocardial necrosis and a rich cellular infiltration of lymphocytes with a few eosinophils, plasma cells, macrophages and multinucleated giant cells. We hereby report a case of IGCM in a 72 year old male with history of sudden death. This case is being presented for its rarity and a review of literature is made.

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    • "Of the several hundred cases reported since the first description in1905, almost all have come from Europe, North America, and East Asia [1]. The Indian literature on GCM consists of a few isolated case reports [2]. The relative lack of data on GCM in India prompted us to systematically review the cases of histologically confirmed GCM from a large referral center and compare these data qualitatively to previous reports from other regions of the world. "
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    ABSTRACT: Background: Giant cell myocarditis (GCM) is a rare disorder that is known primarily from North American, European, and Japanese case series. The clinical and pathological features of GCM in India have not been reported. Methods: We reviewed the pathology records from 1994 to 2010 from a tertiary care referral hospital in Mumbai for all cases of pathologically confirmed GCM. Gross and microscopic histological features and clinical characteristics of the GCM cases were described and qualitatively compared to GCM case series from other regions of the world. Results: The 12 cases of GCM constituted 0.005% of all autopsies and 0.8% of myocarditis cases. Gross pathological features included variably dilated chambers in 8/12 cases with multifocal involvement of the myocardium. Three had regional hypertrophy associated with marked lymphocytic infiltrate. There were unique cases of a posterior wall rupture with hemopericardium and a case with multiple epicardial inflammatory sessile polyps. A novel possible trigger was suggested by a positive serologic test for leptospirosis in one case. The clinical features including age, gender, presenting symptoms, and prognosis resemble those reported in autopsy-based case series from other regions. Conclusions: GCM affects patients in India at approximately the same rate as in Europe and Japan. The clinical and histological features of GCM are similarly severe and suggest a heart-specific autoimmune reaction.
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    ABSTRACT: Giant-cell myocarditis is a disease of relatively young, predominantly healthy adults. The patients usually die of heart failure and ventricular arrhythmia unless a cardiac transplantation is performed. We are reporting here an autopsy case of idiopathic giant cell myocarditis with no symptoms in a 27-year old -worker who died suddenly.The purpose of this report was to emphasize that idiopathic giant cell myocarditis was a rare disease and that it could exist in the absence of any symptomatic heart disease.
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