RESUMEN
Tumor necrosis factor α (TNF-α) antagonists are being increasingly used as maintenance therapies for rheumatic diseases, and therefore knowledge of their adverse effects is important. We report a case of fatal acute necrotizing eosinophilic myocarditis temporally related to use of a second course of the TNF-α antagonist, adalimumab. A 51-year-old woman with relapsing polychondritis took adalimumab 2 weeks before presenting with acute myocarditis. Within hours of presentation to the emergency department, she had cardiac arrest due to fulminant heart failure. Autopsy demonstrated necrotizing eosinophilic myocarditis. This is a rare cause of fulminant heart failure. This is the first report of a TNF-α antagonist potentially associated with acute necrotizing eosinophilic myocarditis.
Asunto(s)
Anticuerpos Monoclonales Humanizados/efectos adversos , Antirreumáticos/efectos adversos , Eosinofilia/inducido químicamente , Miocarditis/inducido químicamente , Policondritis Recurrente/tratamiento farmacológico , Factor de Necrosis Tumoral alfa/antagonistas & inhibidores , Enfermedad Aguda , Adalimumab , Anticuerpos Monoclonales Humanizados/uso terapéutico , Antirreumáticos/uso terapéutico , Autopsia , Comorbilidad , Eosinofilia/epidemiología , Eosinofilia/patología , Resultado Fatal , Femenino , Humanos , Persona de Mediana Edad , Miocarditis/epidemiología , Miocarditis/patología , Miocardio/patologíaRESUMEN
This is a report of a 41-year-old professional male bodybuilder with a history of active anabolic-androgenic steroid abuse and a normal echocardiogram two years prior to admission who experienced a near-fatal arrhythmia during anaesthetic induction for elective orthopaedic surgery. The patient had severe concentric left ventricular hypertrophy, diffuse left ventricular hypokinesis, decreased ejection fraction and inducible monomorphic ventricular tachycardia. A single-chamber cardioverter/defibrillator was inserted.
Asunto(s)
Anestesia/efectos adversos , Arritmias Cardíacas/etiología , Ejercicio Físico/fisiología , Paro Cardíaco/etiología , Adulto , Anabolizantes/administración & dosificación , Andrógenos/administración & dosificación , Arritmias Cardíacas/terapia , Desfibriladores Implantables , Paro Cardíaco/fisiopatología , Paro Cardíaco/terapia , Humanos , Hipertrofia Ventricular Izquierda , Masculino , Trastornos Relacionados con Sustancias/complicaciones , Resultado del Tratamiento , Disfunción Ventricular IzquierdaRESUMEN
Pulmonary artery obstruction may be caused by tumor within or external to the arteries. Presented here is a patient with life-threatening compromise in pulmonary flow that was caused by a pulmonary neoplasm. The Doppler echocardiogram showed subtotal narrowing of the right pulmonary artery and total occlusion of the left pulmonary artery. In addition, the beneficial effects of chemotherapy were documented by Doppler.