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Cardiology Research and Practice
Volume 2011, Article ID 925104, 4 pages
http://dx.doi.org/10.4061/2011/925104
Case Report

Giant Cell Myocarditis with Incessant Ventricular Arrhythmias Treated Successfully with Methylprednisolone and Rat Antithymocyte Globulin

Department of Cardiology, Western Sussex Hospitals NHS Trust, Lyndhurst Road, Worthing, West Sussex BN11 2DH, UK

Received 20 December 2010; Revised 13 February 2011; Accepted 27 February 2011

Academic Editor: Firat Duru

Copyright © 2011 Mudassar Baig and Rob Hatrick. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Giant cell myocarditis is an aggressive form of this condition that is typically progressive and unresponsive to usual medical treatment. Here, we describe a 34-year-old patient presenting with incessant ventricular arrhythmias with hemodynamic compromise who required prolonged support in intensive care with an intra-aortic balloon pump (IABP). His Coronary arteries were normal and LV endomyocardial biopsy revealed myocyte necrosis with inflammatory infiltrate of lymphocytes, eosinophils, and giant cells suggestive of giant cell myocarditis. He was successfully treated with pulsed intravenous methylprednisolone and rat antithymocyte globulin (RATG). Despite a good functional cardiac recovery, some months later he developed a fluctuant neck swelling which fine needle aspiration confirmed as tuberculosis.