Myocarditis and inflammatory bowel diseases: A single-center experience and a systematic literature review

Giordani, Andrea Silvio; Candelora, A.; Fiacca, M.; Cheng, Chun‐Yan; Barberio, Brigida; Baritussio, Anna; Marcolongo, R; Iliceto, Sabino; Carturan, Elisa; Gaspari, Monica De; Rizzo, Stefania; Basso, Cristina; Tarantini, Giuseppe; Savarino, Edoardo; ALP, Caforio

doi:10.1016/j.ijcard.2023.01.071

Cited by 8 publications

(4 citation statements)

References 41 publications

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“…Pericarditis has been correlated in the literature with active UC, especially among male patients, while myocarditis is mostly described in Crohn's disease [2] . This was also described in a recent systematic review among 104 IBD patients, where myocarditis affected mostly young male patients with a median age of 31 years, and it was correlated with acute IBD flare [3] . Myopericarditis was mostly associated with underlying infection, immune-mediated process or druginduced toxicity, especially in cases when mesalamine had been used [3] .…”

Section: Discussionsupporting

confidence: 59%

“…This was also described in a recent systematic review among 104 IBD patients, where myocarditis affected mostly young male patients with a median age of 31 years, and it was correlated with acute IBD flare [3] . Myopericarditis was mostly associated with underlying infection, immune-mediated process or druginduced toxicity, especially in cases when mesalamine had been used [3] . In our case, the initial septic screen tests ruled out the presence of active inflammation, while the patient was biologic-factor naïve, under no recent treatment.…”

Section: Discussionsupporting

confidence: 59%

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Acute severe ulcerative colitis flare complicated by myopericarditis and infliximab-induced hepatitis

Manti,

Nikolaos Kamperidis,

Alexandros Toskas

et al. 2024

European Journal of Case Reports in Internal Medicine

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Ulcerative colitis (UC) is an autoimmune disease associated with both intestinal and extraintestinal manifestations. The latter may include heart complications, such as myopericarditis leading to life-threatening arrythmias. Nowadays, UC is commonly treated with biologic medications and infliximab is the first line therapy in an outpatient setting, while it is also used as rescue therapy in acute severe UC. However, it has been associated with severe immunosuppression, cytomegalovirus (CMV) reactivation and drug-induced hepatitis. We report a case of UC flare in a biologic naïve patient admitted with myopericarditis, which was further complicated by positive CMV biopsies and infliximab-induced transaminitis.

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Section: Discussionsupporting

confidence: 59%

Section: Discussionsupporting

confidence: 59%

Acute severe ulcerative colitis flare complicated by myopericarditis and infliximab-induced hepatitis

Manti,

Nikolaos Kamperidis,

Alexandros Toskas

et al. 2024

European Journal of Case Reports in Internal Medicine

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“…The association of inflammatory bowel disease (IBD) with GCM has been most commonly described. Myocarditis associated with IBD occurs in the acute phase of the disease (67%) and it more frequently affects young males (72%), predominantly presenting with an infarct-like state (58%) (54). Shivaraj et al investigated adult IBD patients from 2010 to 2014, and found that myocarditis was present in 0.01% patients, specifically 0.018% in ulcerative colitis, and 0.009% in Crohn's disease (55).…”

Section: Histopathological Findings Potential Etiological Factors And...mentioning

confidence: 99%

Giant cell myocarditis in modern clinical practice

Lasica,

Đukanović,

Zdravković

et al. 2023

Medicinska istraživanja

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Giant cell myocarditis is a rare but extremely severe disease with a frequent need for heart transplantation and a high mortality rate. To this day, the most common reason for the occurrence of this disease has not been precisely determined, but its frequent association with autoimmune diseases speaks in favor of autoimmune etiology. Clinically, it is presented to the greatest extent by symptoms and signs of acute heart failure and ventricular rhythm disturbances, which are registered in as many as half of the patients. Arrhythmias can be accompanied by the occurrence of palpitations, repeated syncope, and even sudden cardiac death. A severe degree of acute heart failure in hemodynamically unstable patents who respond inadequately to the administered therapy for heart failure and refractory heart rhythm disorders and/or conduction disorders that are common in these patients should always raise suspicion of giant cell myocarditis. Given that changes in electrocardiogram, echocardiography and positive biomarker values are not strictly specific for this disease, the diagnosis of giant cell myocarditis is most often established by endomyocardial biopsy, especially in patients with the fulminant form of the disease. Timely endomyocardial biopsy enables not only quick and accurate diagnosis, but also early administration of immunosuppressive therapy, which greatly improves the outcome in these patients. Pathohistological verification of this disease is important so as to rule out cardiac sarcoidosis and other granulomatous infectious and non-infectious diseases. Given that in a large number of patients the disease has a fulminant course, early and rapid diagnosis, application of inotropic stimulation and mechanical circulatory support in hemodynamically unstable patients and adequate modern therapeutic regimen can largely reduce mortality in these patients, which is still high despite modern diagnostics and therapeutic progress of medicine.

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“…Nearly 7 million people suffer from IBD worldwide, mostly in Europe (2 million) and America (1.5 million) and the incidence of the disease is rising [2]. Both CD and UC lead to chronic inflammation of the gut, but inflammation may also affect other organs, causing extraintestinal manifestations [3][4][5][6]. Moreover, both conditions are associated with impaired quality of life and increased disability [7][8][9].…”

Section: Introductionmentioning

confidence: 99%

Extraintestinal Cancers in Inflammatory Bowel Disease: A Literature Review

Massano

Bertin

Zingone

et al. 2023

Cancers

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Background: Inflammatory bowel disease (IBD) is a group of chronic multifactorial inflammatory disorders including two major entities: Crohn’s disease (CD) and ulcerative colitis (UC). Preliminary evidence suggests that patients with IBD may be at increased risk of developing intestinal and extraintestinal cancers (EICs). Actually, little is known about the association between IBD and EICs, and there is ever-growing concern regarding the safety of immunomodulators and biological therapy, which may represent a risk factor for carcinogenesis. Aims: The aim of this review is to summarize the evidence regarding the association between IBD and EICs, the safety of immunomodulators and biological therapy and the management of immunomodulators and biologic agents in IBD patients with prior or current EICs. Results: IBD patients have a higher risk of developing different forms of extraintestinal solid organ tumors and hematological malignancies. Immunomodulators and biological therapy may increase the risk of developing some types of EICs and may be consciously used in patients with IBD and current or prior history of malignancy. Conclusions: Decisions regarding the use of immunomodulators or biological therapies should be made on an individual basis, considering a multidisciplinary approach involving oncologists.

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Myocarditis and inflammatory bowel diseases: A single-center experience and a systematic literature review

Cited by 8 publications

References 41 publications

Acute severe ulcerative colitis flare complicated by myopericarditis and infliximab-induced hepatitis

Acute severe ulcerative colitis flare complicated by myopericarditis and infliximab-induced hepatitis

Giant cell myocarditis in modern clinical practice

Extraintestinal Cancers in Inflammatory Bowel Disease: A Literature Review

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