A rare case of acute 'infective' myocardial infarction triggered by acute parvovirus B19 myocarditis

Gutersohn, Achim; Zimmermann, U.; Bartel, Thomas; Erbel, Raimund

doi:10.1038/ncpcardio0126

Cited by 7 publications

(7 citation statements)

References 11 publications

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“…Other B19 associated disorders B19 has a cardiotropic potential as P-ag is expressed by myocytes and B19 DNA has indeed been detected in heart tissue [24,43,109]. Cases of sometimes fatal myocarditis and heart failure in both children and adults have been reported [110][111][112][113][114][115].…”

Section: Patients With Increased Red Cell Turnovermentioning

confidence: 99%

Clinical aspects of parvovirus B19 infection

Broliden

Tolfvenstam

Norbeck

2006

Journal of Internal Medicine

184

203

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Parvovirus B19 is a significant human pathogen that causes a wide spectrum of clinical complications ranging from mild, self-limiting erythema infectiosum in immunocompetent children to lethal cytopenias in immunocompromised patients and intrauterine foetal death in primary infected pregnant women. The infection may also be persistent and can mimic or trigger autoimmune inflammatory disorders. Another important clinical aspect to consider is the risk of infection through B19-contaminated blood products. Recent advances in diagnosis and pathogenesis, new insights in the cellular immune response and newly discovered genotypes of human parvoviruses form a platform for the development of modern therapeutic and prophylactic alternatives.

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Section: Patients With Increased Red Cell Turnovermentioning

confidence: 99%

Clinical aspects of parvovirus B19 infection

Broliden

Tolfvenstam

Norbeck

2006

Journal of Internal Medicine

184

203

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“…Case reports describing modern antiplatelet agents to cause dyspnoea are rare (1–8). Neither systematic reviews nor repeated observations on this issue exist in the literature.…”

Section: Main Causes Of Dyspnoeamentioning

confidence: 99%

“…Investigational drugs per se are not attributable causes of dyspnoea, but rather it has been ascribed to the existing clinical condition of the patient in whom antiplatelet medication has been used. Nevertheless, anecdotal evidence has suggested that aspirin (2), ticlopidine (3,4), clopidogrel (5), cilostazol (6), abciximab (7) or eptifibatide (8) may cause dyspnoea. There are numerous observations linking dipyridamole with dyspnoea, but all cases occur during diagnostic perfusion cardiac imaging, and are not attributed to with Aggrenox (extended released dipyridamole combined with low‐dose aspirin) approved for secondary stroke prevention (9,10).…”

Section: Main Causes Of Dyspnoeamentioning

confidence: 99%

Dyspnoea after antiplatelet agents: the AZD6140 controversy

Serebruany

Stebbing

Atar

2007

International Journal of Clinical Practice

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Recent randomised studies suggest that experimental oral reversible platelet P2Y12 receptor inhibitor, AZD6140, causes dyspnoea. This also raises similar concerns about the parent compound, and another adenosine triphosphate (ATP) analogue (AR-69931MX or cangrelor), which is currently in Phase 3 trial in patients undergoing coronary interventions. We analysed package inserts, and available clinical trials safety data for antiplatelet agents with regard to the incidence of dyspnoea. We found that dyspnoea is a very rare complication of the presently approved platelet inhibitors, mostly caused by underlying disease, rather than antiplatelet therapy per se. The main reasons for respiratory distress after oral (AZD6140), and intravenous (cangrelor) agents may be the development of mild asymptomatic thrombotic thrombocytopenic purpura, fluid retention and dyspnoea because of the reversible nature of these drugs. Also, these agents are ATP analogues, which rapidly metabolise to adenosine, a well-known bronchoprovocator causing dyspnoea as well. In summary, dyspnoea is seldom considered, there are no treatment algorithms when it does occur, plausible mechanisms exist and despite these plausible mechanisms, the true cause of dyspnoea in these exposed individuals is unknown. Additional pulmonary function testing, immunological investigations and platelet receptor studies are urgently needed to determine the cause of dyspnoea after AZD6140, and to point out how such serious adverse reactions can be prevented, or at least minimised, raising potential concerns about this drug.

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“…In two AMC patients (P14, P15) and one DCM patient (P11) viremia was evident in initial and/or follow-up sera, pointing to a potential involvement of the virus in heart disease in these cases. [41][42][43][44] The non-significant tendency for higher myocardial B19V-loads in viremic patients may be also considered as an indication of active viral replication in the myocardium. However, large-scale investigations are warranted to address this issue.…”

Section: Discussionmentioning

confidence: 99%