[Myocarditis in childhood: results of a decade's research]

The research of the last decade gave new insights in the pathogenesis of viral myocarditis. The virus infection of the myocardium may be controlled by the infiltrating inflammatory cells and heal with more or less scarring. An autoimmune mediated chronic inflammation is observed as well as the persistence of virus genoms, which causes with low replication rate again chronic inflammation. The immunohistochemical characterization of the infiltrating immune cells and the molecular biological proof of virus genoms in endomyocardial specimens allow a sensitive diagnostic of the various forms of myocarditis and should guide therapy. Until now treatment trials did not differentiate between these various forms, had no control groups or very small numbers of patients. Two multicenter treatment trials in Germany referring to immunosuppressive or interferon therapy in children and adults may give--provided a better participation--recommendations for therapy.