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Intravenous Gamma-Globulin Therapy in Myocarditis Complicated with Complete Heart Block: Report of One Case

免疫球蛋白治療於心肌炎併發完全房室傳導阻斷:一病例報告

摘要


心肌炎合併完全房室傳導阻斷在孩童相當少見,心肌炎中心肌之受損部份份藉著免疫機轉而造成,高劑量免疫球蛋白乃一免疫調節劑,對心股炎中心臟功能有改善的效果。我們報導一名四歲男孩可能因徵漿菌感染後,引發心肌炎併合並完全房室傳導阻斷以及心因性休克,經緊急放置經皮暫性心臟節律器,以及高劑量免疫球蛋白輔助治療,心臟機能障礙逐漸改善,以及節律在住院十小時後恢復正常,出字並追蹤六個月,心臟功能正常,並無節律不整的問題。

並列摘要


Myocarditis complicated with complete heart block is rare in childhood. We report a case of 4-year-old child presented with complete heart block which may have been caused by Mycoplasma pneumoniae. Under emergent temporal pacing, patient experienced cardiogenic shock with pulmonary edema eventually. The cardiopulmonary function was improved with atrial rhythm at the 6th hour later after intravenous infusion with high-dose gamma-globulin (IVIG). The IVIG therapy may have immunomodulatory effects and serve as a potential adjunctive therapy for fulminant myocarditis.

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