Myocarditis with Advanced Atrioventricular Block after Allogeneic Stem Cell Transplantation: A Case Report and Literature Review

• Published in: Internal Medicine Vol. 59; no. 1; pp. 113 - 118
• Main Authors: Sumi, Masahiko, Kitahara, Mari, Shishido, Tsutomu, Kazumoto, Hiroko, Uematsu, Nozomu, Kirihara, Takehiko, Sato, Keijiro, Ueki, Toshimitsu, Hiroshima, Yuki, Shimizu, Kunihiko, Kobayashi, Hikaru
• Format: Journal Article
• Language: English
• Published: Japan The Japanese Society of Internal Medicine 01.01.2020; Japan Science and Technology Agency
• Subjects: Acute lymphoblastic leukemia; allogeneic stem cell transplantation; atrioventricular block; Atrioventricular Block - diagnosis; Atrioventricular Block - drug therapy; Atrioventricular Block - etiology; Cardiography; Case Report; Cord blood; Cord Blood Stem Cell Transplantation; Echocardiography; Electrocardiography; Female; Glucocorticoids - therapeutic use; Graft vs Host Disease - complications; Graft vs Host Disease - diagnosis; Graft vs Host Disease - drug therapy; graft-versus-host disease; Heart; Heart diseases; Humans; Interferon; Internal medicine; Laboratory tests; Leukemia; Literature reviews; Lymphatic leukemia; Middle Aged; Myocarditis; Myocarditis - diagnosis; Myocarditis - drug therapy; Myocarditis - etiology; Myocardium; Philadelphia chromosome; Precursor Cell Lymphoblastic Leukemia-Lymphoma - therapy; Prednisolone; Prednisolone - therapeutic use; Shock, Cardiogenic - diagnosis; Shock, Cardiogenic - etiology; Stem cell transplantation; Stem cells; Transplantation; Ventricle; α-Interferon; allogeneic stem cell transplantation; atrioventricular block; myocarditis; graft-versus-host disease
• ISSN: 0918-2918; 1349-7235
• DOI: 10.2169/internalmedicine.3322-19

A 51-year-old woman with Philadelphia chromosome-positive acute lymphoblastic leukemia underwent a second cord blood transplantation followed by maintenance therapy with interferon-α. After 33 months, she developed cardiogenic shock caused by advanced atrioventricular block. Laboratory tests revealed increased myocardium enzymes, and ultrasonic cardiography demonstrated mild thickening of the left ventricular wall. She was diagnosed with myocarditis and successfully treated using prednisolone. Myocarditis after allogeneic stem cell transplantation is a rare but potentially fatal complication. However, it is important for physicians to be aware of this complication because all of the symptoms may be reversed with immunosuppressive treatment.