Acute Myopericarditis After Multiple Vaccinations in an Adolescent: Case Report and Review of the Literature

Thanjan, Maria T; Ramaswamy, Prema; Lai, Wyman W.; Lytrivi, Irene D.

doi:10.1542/peds.2006-2605

Cited by 19 publications

(10 citation statements)

References 16 publications

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“…In the only previous report of an infant with eosinophilic myocarditis who suddenly died of presumptive arrhythmia, however, histologic evaluation of the heart revealed degeneration of conduction fibers adjacent to areas of significant eosinophilic endocardial and subendocardial infiltration infiltration. 8 This would support the importance of long-term follow-up even if the arrhythmia has clinically resolved.…”

Section: Commentmentioning

confidence: 88%

“…Although the vast majority of acute myocarditis in the pediatric population is due to viral infection, our patient had eosinophils in the myocardium suggesting hypersensitivity as a possible primary or contributing etiology. While rarely reported in pediatric patients 8–12 and largely in older children, eosinophilic myocarditis is well‐described in adults and occurs in Loffler's disease, vasculitic and granulomalous diseases (e.g., Churg‐Strauss syndrome), parasitic infections, and hypersensitivity reactions 13 . These conditions are usually associated with eosinophilia in the circulating peripheral blood; however, several reports have documented normal or only mildly increased eosinophil blood counts particularly associated with medication‐induced, biopsy‐confirmed eosinophilic myocarditis 14–16 .…”

Section: Commentmentioning

confidence: 99%

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Hypersensitivity Myocarditis Presenting as Atrioventricular Block and Wide Complex Tachycardia in a Toddler

Bhogal

Grady

Ursell

et al. 2008

Congenital Heart Disease

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A 13-month-old boy presented with acute onset of complete atrioventricular block and wide complex tachycardia but normal hemodynamics. Endomyocardial biopsy disclosed active myocarditis with eosinophils, suggesting a hypersensitivity reaction. With no treatment, the rhythm disturbance resolved within days of onset. Our patient's presentation and self-limited illness is unique. To our knowledge, this is only the second reported case of eosinophilic myocarditis in a young child or infant.

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Section: Commentmentioning

confidence: 88%

Section: Commentmentioning

confidence: 99%

Hypersensitivity Myocarditis Presenting as Atrioventricular Block and Wide Complex Tachycardia in a Toddler

Bhogal

Grady

Ursell

et al. 2008

Congenital Heart Disease

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“…Increased cTn can be a better indicator of the presence of cardiac damage than other indicators such as the ECG (49 ). Perimyocarditis should be considered if MI has been ruled out in a patient with dyspnea and chest discomfort, especially with a history of recent viral illness (50 ).…”

Section: Thrombotic Thrombocytopenic Purpura (Ttp)mentioning

confidence: 99%

Increases of Cardiac Troponin in Conditions other than Acute Coronary Syndrome and Heart Failure

2009

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Background: Although cardiac troponin (cTn) is a cornerstone marker in the assessment and management of patients with acute coronary syndrome (ACS) and heart failure (HF), cTn is not diagnostically specific for any single myocardial disease process. This narrative review discusses increases in cTn that result from acute and chronic diseases, iatrogenic causes, and myocardial injury other than ACS and HF.Content: Increased cTn concentrations have been reported in cardiac, vascular, and respiratory disease and in association with infectious processes. In cases involving acute aortic dissection, cerebrovascular accident, treatment in an intensive care unit, and upper gastrointestinal bleeding, increased cTn predicts a longer time to diagnosis and treatment, increased length of hospital stay, and increased mortality. cTn increases are diagnostically and prognostically useful in patients with cardiac inflammatory diseases and in patients with respiratory disease; in respiratory disease cTn can help identify patients who would benefit from aggressive management. In chronic renal failure patients the diagnostic sensitivity of cTn for ACS is decreased, but cTn is prognostic for the development of cardiovascular disease. cTn also provides useful information when increases are attributable to various iatrogenic causes and blunt chest trauma.Summary: Information on the diagnostic and prognostic uses of cTn in conditions other than ACS and heart failure is accumulating. Although increased cTn in settings other than ACS or heart failure is frequently considered a clinical confounder, the astute physician must be able to interpret cTn as a dynamic marker of myocardial damage, using clinical acumen to determine the source and significance of any reported cTn increase.

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“…In the past, the association between an increased risk of myocarditis and the use of smallpox vaccine, both in military personnel and civilians, drew the attention of clinicians and regulators [ 1 ]. Cases of myocarditis, pericarditis or myopericarditis after other vaccines, including multiple immunization have been reported as well, but a definite association was never demonstrated [ 2 – 4 ]. Here below, we describe a case of established pericarditis in an elderly patient following seasonal influenza vaccine with unintentional re-challenge.…”

Section: Introductionmentioning

confidence: 99%

Recurrence of pericarditis after influenza vaccination: a case report and review of the literature

Mei

Raschi

Poluzzi

et al. 2018

BMC Pharmacol Toxicol

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BackgroundThis case report describes a patient with pericarditis likely attributed to influenza vaccination (positive rechallenge), with a literature review.Case presentationA 87-year old patient developed pericarditis after influenza vaccination, with acute chest pain, without ECG abnormalities or increased cardiac enzyme levels. Echocardiogram showed moderate pericardial effusion. Recovery was obtained through steroids One year later, few days after re-immunization, the patient experienced the same symptoms and was admitted to hospital with diagnosis of recurrence of pericarditis with severe pericardial effusion, again treated with steroids. Other possible causes were ruled out and the cardiologist recommended against influenza vaccinations in the future; the patient did not experience recurrence of pericarditis in the following 6 years. Cases of pericarditis following influenza immunization in the literature were also reviewed.ConclusionsPericarditis following immunization for influenza is very rarely reported in the literature. In a few cases, influenza vaccination seems likely responsible. We suggest considering recent immunization in patient’s history as part of the differential diagnosis in elderly with chest pain.

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Acute Myopericarditis After Multiple Vaccinations in an Adolescent: Case Report and Review of the Literature

Cited by 19 publications

References 16 publications

Hypersensitivity Myocarditis Presenting as Atrioventricular Block and Wide Complex Tachycardia in a Toddler

Hypersensitivity Myocarditis Presenting as Atrioventricular Block and Wide Complex Tachycardia in a Toddler

Increases of Cardiac Troponin in Conditions other than Acute Coronary Syndrome and Heart Failure

Recurrence of pericarditis after influenza vaccination: a case report and review of the literature

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