Fatal course of parvovirus B19‐associated myocarditis in a female liver transplant recipient

Acute myocarditis may result in severe hemodynamic compromise with fatal outcome. Furthermore, recent studies suggest myocarditis as a major cause of sudden unexpected death. A variety of cardiotropic viral, rickettsial, and bacterial infectious agents have been identified to date. Parvovirus B19 (P...

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Published inLiver transplantation Vol. 11; no. 4; pp. 463 - 466
Main Authors Jonetzko, Patrycja, Graziadei, Ivo, Nachbaur, Karin, Vogel, Wolfgang, Pankuweit, Sabine, Zwick, Ralf, Pachinger, Otmar, Poelzl, Gerhard
Format Journal Article
LanguageEnglish
Published Hoboken Wiley Subscription Services, Inc., A Wiley Company 01.04.2005
Subjects
Acute Disease
Aged
DNA, Viral - genetics
Fatal Outcome
Female
Genome, Viral
Humans
Liver Transplantation
Myocarditis - complications
Myocarditis - virology
Parvoviridae Infections - complications
Parvovirus B19, Human - genetics
Postoperative Complications - virology
Shock, Cardiogenic - etiology
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Summary:Acute myocarditis may result in severe hemodynamic compromise with fatal outcome. Furthermore, recent studies suggest myocarditis as a major cause of sudden unexpected death. A variety of cardiotropic viral, rickettsial, and bacterial infectious agents have been identified to date. Parvovirus B19 (PVB19) is usually benign in childhood, but it may also cause death due to myocarditis. We present here the case of an adult female who presented with fatigue, dyspnea on exertion, and orthostatic dizziness 8 months after successful liver transplantation. Cardiologic work‐up, including left ventricular endomyocardial biopsy, revealed acute myocarditis secondary to PVB19. Since no specific therapy for this virus is available, the patient was treated symptomatically with an angiotensin‐converting enzyme inhibitor plus beta‐blocker and diuretics. After a period of stabilization, new‐onset rapid atrial fibrillation caused acute low‐output syndrome within 14 days after hospital admission. The patient eventually died because of refractory cardiogenic shock. In conclusion, to our knowledge this is the first report of PVB19‐induced myocarditis confirmed by detection of viral genome in myocardium in a liver transplant recipient. (Liver Transpl 2005;11:463–466.)
Bibliography:Telephone: 43 512 504 81313; FAX: 43 512 504 23264
ObjectType-Case Study-2
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ISSN:1527-6465
1527-6473
DOI:10.1002/lt.20375