Abstract
BackgroundHigh-dose steroids and intravenous immunoglobulin (IVIG) are controversial treatments for pediatric patients with acute myocarditis. This study aimed to investigate their efficacies in the Taiwanese pediatric population.MethodsThis study evaluated 5563 acute myocarditis patients from the Taiwan’s National Health Insurance Research Database and identified 1542 pediatric patients hospitalized for acute myocarditis between January 1, 2001 and December 31, 2011. The exclusion criteria were age of > 11 years, associated cardiovascular comorbidities, autoimmune disease, malignancy before the index hospitalization, extracorporeal membrane oxygenation, intra-aortic balloon pumping, and dual therapy using IVIG and high-dose steroids.ResultsAfter 2:1 propensity score matching, we identified 208 subjects without steroid therapy and 104 subjects who received high-dose steroids. The mean age in that cohort was 2.6 ± 2.9 years, and high-dose steroid therapy had no significant effects on major in-hospital complications and post-discharge outcomes. After 2:1 propensity score matching, we identified 178 subjects without IVIG therapy and 89 subjects who received IVIG. The mean age in that cohort was 2.0 ± 2.1 years, and IVIG had no significant effects on the major outcomes.ConclusionsThe present study revealed that high-dose steroid or IVIG therapy had no significant effects on major in-hospital complications, late heart failure hospitalization, and long-term mortality.
Highlights
High-dose steroids and intravenous immunoglobulin (IVIG) are controversial treatments for pediatric patients with acute myocarditis
Acute myocarditis is defined as inflammation of the myocardium that is related to viral infection and autoimmune reactions [1], which may lead to the sudden onset of heart failure, arrhythmia, fulminant hemodynamic collapse, and death
This condition is common in the pediatric population, as approximately 55% of autopsied pediatric patients were diagnosed with myocarditis [2]
Summary
High-dose steroids and intravenous immunoglobulin (IVIG) are controversial treatments for pediatric patients with acute myocarditis. Acute myocarditis is defined as inflammation of the myocardium that is related to viral infection and autoimmune reactions [1], which may lead to the sudden onset of heart failure, arrhythmia, fulminant hemodynamic collapse, and death. This condition is common in the pediatric population, as approximately 55% of autopsied pediatric patients were diagnosed with myocarditis [2]. The present study aimed to evaluate the effects of high-dose steroid and IVIG therapy on Taiwanese pediatric patients with acute myocarditis using data from a nationally representative cohort
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
