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Carnitine supplementation in diphtheria.

A C Ramos1, L Barrucand, P R Elias

  • 1Department of Pediatrics, UFRJ, Rio de Janeiro, Brasil.

Indian Pediatrics
|December 1, 1992
PubMed
Summary
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Carnitine supplementation significantly reduced myocarditis incidence and mortality in children with diphtheria. This finding supports routine carnitine use for diphtheria patients to improve outcomes.

Area of Science:

  • Pediatric Infectious Diseases
  • Cardiology
  • Nutritional Biochemistry

Background:

  • Diphtheria remains a significant global health concern, particularly in unvaccinated populations.
  • Myocarditis is a serious complication of diphtheria, leading to increased morbidity and mortality.
  • The role of carnitine in managing infectious diseases and their complications is an area of ongoing research.

Purpose of the Study:

  • To investigate the efficacy of DL-carnitine supplementation in reducing the incidence and mortality of myocarditis in pediatric diphtheria patients.
  • To evaluate the impact of carnitine on the clinical course of diphtheria when added to standard treatment.

Main Methods:

  • A randomized controlled trial involving 625 children diagnosed with diphtheria.
  • Participants received either DL-carnitine (100 mg/kg/day orally for four days) or no carnitine, alongside routine diphtheria treatment.

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  • Patients were matched for age, sex, symptom duration, toxemia grade, and immunization status.

    • Main Results:

    • Carnitine supplementation led to a statistically significant reduction in the incidence of myocarditis (p = 0.001).
    • Among patients who developed myocarditis, carnitine therapy resulted in a significant decrease in mortality (p < 0.001).
    • No significant differences were noted in other matched parameters between the carnitine and control groups.

    Conclusions:

    • DL-carnitine supplementation demonstrates a significant protective effect against myocarditis in diphtheria.
    • Carnitine therapy is associated with reduced mortality in diphtheria patients who develop myocarditis.
    • Routine carnitine supplementation is recommended for all diphtheria cases to mitigate the risk and severity of myocarditis.