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A fatal case of fulminant myocarditis with human herpesvirus-6 infection
S Fukae1, N Ashizawa, S Morikawa
1Third Department of Internal Medicine, Nagasaki University School of Medicine.
Insights
Steroid pulse therapy for acute hepatitis can trigger fulminant myocarditis. Reactivation of human herpesvirus-6 (HHV-6) due to immunosuppression is a likely cause of this severe cardiac complication.
Area of Science:
- Virology
- Immunology
- Cardiology
Background:
- Acute hepatitis treatment often involves immunosuppressive therapies like steroid pulse therapy.
- Fulminant myocarditis is a rare but life-threatening inflammation of the heart muscle.
Observation:
- A patient developed fulminant myocarditis following steroid pulse therapy for acute hepatitis.
- Serological tests revealed a significant increase in antibodies against human herpesvirus-6 (HHV-6).
Findings:
- Polymerase chain reaction (PCR) confirmed the presence of HHV-6 viral DNA in both liver and heart tissues.
- The study suggests a link between HHV-6 reactivation and the exacerbation of fulminant myocarditis.
Implications:
- This case highlights the potential risk of viral reactivation, specifically HHV-6, in immunosuppressed patients.
- Understanding this association may inform clinical management and preventative strategies for myocarditis in hepatitis patients undergoing immunosuppression.
Abstract:
We report a case of fulminant myocarditis after steroid pulse therapy for acute hepatitis. Serological studies demonstrated a four-fold increase in the antibodies against human herpesvirus-6 (HHV-6) IgG, and a PCR showed the existence of HHV-6 virus DNA. HHV-6 virus DNA was also isolated from the liver and the heart. We believe that exacerbation of fulminant myocarditis was probably associated with the reactivation of HHV-6 due to the immunosuppressive state of the host.