Your browser doesn't support javascript.
loading
Recurrent Cardiac Sarcoidosis and Giant Cell Myocarditis After Heart Transplant: A Case Report and Systematic Literature Review.
Stein, Andrew P; Stewart, Brian D; Patel, Divya C; Al-Ani, Mohammad; Vilaro, Juan; Aranda, Juan M; Ahmed, Mustafa M; Parker, Alex M.
Afiliación
  • Stein AP; Department of Medicine. Electronic address: andrew.stein@medicine.ufl.edu.
  • Stewart BD; Department of Pathology.
  • Patel DC; Division of Pulmonary, Critical Care and Sleep Medicine.
  • Al-Ani M; Division of Cardiology, Department of Medicine, University of Florida Gainesville, Florida.
  • Vilaro J; Division of Cardiology, Department of Medicine, University of Florida Gainesville, Florida.
  • Aranda JM; Division of Cardiology, Department of Medicine, University of Florida Gainesville, Florida.
  • Ahmed MM; Division of Cardiology, Department of Medicine, University of Florida Gainesville, Florida.
  • Parker AM; Division of Cardiology, Department of Medicine, University of Florida Gainesville, Florida.
Am J Cardiol ; 207: 271-279, 2023 11 15.
Article en En | MEDLINE | ID: mdl-37769570
Recurrence of cardiac sarcoidosis (CS) and giant cell myocarditis (GCM) after heart transplant is rare, with rates of 5% in CS and 8% in GCM. We aim to identify all reported cases of recurrence in the literature and to assess clinical course, treatments, and outcomes to improve understanding of the conditions. A systematic review, utilizing Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines, was conducted by searching MEDLINE/PubMed and Embase of all available literature describing post-transplant recurrent granulomatous myocarditis, CS, or GCM. Data on demographics, transplant, recurrence, management, and outcomes data were collected from each publication. Comparison between the 2 groups were made using standard statistical approaches. Post-transplant GM recurrence was identified in 39 patients in 33 total publications. Reported cases included 24 GCM, 12 CS, and 3 suspected cases. Case reports were the most frequent form of publication. Mean age of patients experiencing recurrence was 42 years for GCM and 48 years for CS and favored males (62%). Time to recurrence ranged from 2 weeks to 9 years post-transplant, occurring earlier in GCM (mean 1.8 vs 3.0 years). Endomyocardial biopsies (89%) were the most utilized diagnostic method over cardiac magnetic resonance and positron emission tomography. Recurrence treatment regimens involved only steroids in 40% of CS, whereas other immunomodulatory regimens were utilized in 70% of GCM. In conclusion, GCM and CS recurrence after cardiac transplantation holds associated risks including concurrent acute cellular rejection, a higher therapeutic demand for GCM recurrence compared with CS, and mortality. New noninvasive screening techniques may help modify post-transplant monitoring regimens to increase both early detection and treatment of recurrence.
Asunto(s)
Palabras clave

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Sarcoidosis / Trasplante de Corazón / Cardiomiopatías / Miocarditis Tipo de estudio: Guideline / Screening_studies / Systematic_reviews Límite: Adult / Humans / Male Idioma: En Revista: Am J Cardiol Año: 2023 Tipo del documento: Article Pais de publicación: Estados Unidos

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Sarcoidosis / Trasplante de Corazón / Cardiomiopatías / Miocarditis Tipo de estudio: Guideline / Screening_studies / Systematic_reviews Límite: Adult / Humans / Male Idioma: En Revista: Am J Cardiol Año: 2023 Tipo del documento: Article Pais de publicación: Estados Unidos