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

Intern Med. 2020 Jan 1;59(1):113-118. doi: 10.2169/internalmedicine.3322-19. Epub 2019 Aug 28.

Abstract

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.

Keywords: allogeneic stem cell transplantation; atrioventricular block; graft-versus-host disease; myocarditis.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Atrioventricular Block / diagnosis
  • Atrioventricular Block / drug therapy
  • Atrioventricular Block / etiology*
  • Cord Blood Stem Cell Transplantation*
  • Female
  • Glucocorticoids / therapeutic use
  • Graft vs Host Disease / complications*
  • Graft vs Host Disease / diagnosis
  • Graft vs Host Disease / drug therapy
  • Humans
  • Middle Aged
  • Myocarditis / diagnosis
  • Myocarditis / drug therapy
  • Myocarditis / etiology*
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / therapy*
  • Prednisolone / therapeutic use
  • Shock, Cardiogenic / diagnosis
  • Shock, Cardiogenic / etiology

Substances

  • Glucocorticoids
  • Prednisolone