Interferon-beta and corticosteroid therapy for parvovirus B19 myocarditis in children
Ferran Gran1, Paola Dolader1, Diana Carolina Juzga-Corrales1
1Pediatric Cardiology, Vall d'Hebron Hospital Campus, Barcelona, Spain.
Insights
This study shows that combining interferon-beta (IFN-β) with corticosteroids effectively treats pediatric parvovirus B19 myocarditis, leading to rapid recovery in all patients. This combination therapy offers a promising approach for severe cases.
Area of Science:
- Pediatric Cardiology
- Viral Myocarditis
- Immunomodulatory Therapy
Background:
- Parvovirus B19 (PVB19) is a significant cause of acute myocarditis in children, often leading to severe outcomes.
- Interferon-beta (IFN-β) shows potential in adults, but pediatric data for PVB19 myocarditis is limited.
Purpose of the Study:
- To evaluate the clinical experience of using interferon-beta (IFN-β) combined with corticosteroids for pediatric PVB19 myocarditis.
- To assess the efficacy and safety of this combined treatment approach in a pediatric cohort.
Main Methods:
- Prospective cohort study over 9 years (May 2015-September 2024).
- Included pediatric patients diagnosed with PVB19-myocarditis confirmed by endomyocardial biopsy (EMB).
- Treatment involved a six-month course of combined IFN-β and corticosteroids.
Main Results:
- 12 patients (13 episodes) received combined IFN-β and corticosteroid therapy.
- All patients showed clinical and echocardiographic improvement within 2 weeks.
- Complete recovery was achieved in all patients within a median of 59 days post-treatment.
Conclusions:
- Combined IFN-β and corticosteroid therapy appears effective in improving outcomes for pediatric PVB19 myocarditis.
- This approach is recommended for severe cases or those with incomplete recovery.
- Further multicenter studies are needed to confirm findings and establish guidelines.
Background:
Parvovirus B19 (PVB19) is a leading cause of acute myocarditis in children and carries a high risk of mortality or the need for cardiac transplantation. While interferon-beta (IFN-β) has demonstrated modest improvement in adult patients with dilated cardiomyopathy associated with PVB19 infection, clinical experience in pediatric populations remains limited. The objective of this study is to present our clinical experience with IFN-β and corticosteroids in pediatric patients with PVB19 myocarditis.
Methods:
A prospective cohort study was conducted for 9 years (from May 2015 to September 2024), including pediatric patients diagnosed with PVB19-myocarditis who were treated with a combination of IFN-β and steroids. The diagnosis was confirmed by endomyocardial biopsy (EMB).
Results:
A total of 12 patients with 13 episodes of PVB19-myocarditis were treated with a combination of IFN-β and steroids for six months. The median age was 16 months (9.5-31.5), and 50 % were male. Four patients were on extracorporeal membrane oxygenation (ECMO) when treatment commenced. All diagnoses were confirmed by EMB. After 2 weeks receiving IFN-β and corticosteroid therapy, all patients demonstrated clinical and echocardiographic improvement. Complete recovery was achieved in all of them after a median of 59 days (IQR 158.5), post-treatment initiation.
Conclusions:
Our findings suggest that the combination of IFN-β and corticosteroids could improve outcomes in pediatric patients with this disease. This approach should be considered for patients with severe presentation, incomplete recovery or limited improvement. Multicenter studies are warranted to validate these results and establish definitive guidelines for the management of PVB19-myocarditis.
