Skip to main content
NCBI home page
Postgraduate Medical Journal logoLink to Postgraduate Medical Journal
. 1994 Sep;70(827):658–660. doi: 10.1136/pgmj.70.827.658

Cytomegalovirus myocarditis following liver transplantation.

W A Stack 1, H E Mulcahy 1, L Fenelon 1, J E Hegarty 1
PMCID: PMC2397736  PMID: 7971635

Abstract

Cytomegalovirus (CMV) infections are commonly found in patients on immunosuppressive therapy following liver transplantation. However, acute myocarditis is an extremely rare manifestation of CMV infection in this setting. We report the case of a patient who developed acute myocarditis with severe biventricular failure with a cardiac ejection fraction of less than 10%, 6 weeks following orthotopic liver transplantation. Systemic CMV infection was diagnosed on the basis of a clinical viraemia, the presence of CMV antigen in urine, blood, and throat swab, and an associated four-fold rise in serum antibody titres to CMV. A full recovery ensued following treatment with standard anti-cardiac failure therapy and a 10 day course of intravenous ganciclovir.

Full text

PDF
658

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Baandrup U., Florio R. A., Olsen E. G. Do endomyocardial biopsies represent the morphology of the rest of the myocardium? A quantitative light microscopic study of single v. multiple biopsies with the King's bioptome. Eur Heart J. 1982 Apr;3(2):171–178. doi: 10.1093/oxfordjournals.eurheartj.a061281. [DOI] [PubMed] [Google Scholar]
  2. Barkholt L. M., Ericzon B. G., Ehrnst A., Forsgren M., Andersson J. P. Cytomegalovirus infections in liver transplant patients: incidence and outcome. Transplant Proc. 1990 Feb;22(1):235–237. [PubMed] [Google Scholar]
  3. Erice A., Jordan M. C., Chace B. A., Fletcher C., Chinnock B. J., Balfour H. H., Jr Ganciclovir treatment of cytomegalovirus disease in transplant recipients and other immunocompromised hosts. JAMA. 1987 Jun 12;257(22):3082–3087. [PubMed] [Google Scholar]
  4. Gonwa T. A., Capehart J. E., Pilcher J. W., Alivizatos P. A. Cytomegalovirus myocarditis as a cause of cardiac dysfunction in a heart transplant recipient. Transplantation. 1989 Jan;47(1):197–199. [PubMed] [Google Scholar]
  5. Ho M. Virus infections after transplantation in man. Brief review. Arch Virol. 1977;55(1-2):1–24. doi: 10.1007/BF01314475. [DOI] [PubMed] [Google Scholar]
  6. Markin R. S., Hollins S., Wood R. P., Shaw B. W., Jr Main autopsy findings in liver transplant patients. Mod Pathol. 1989 Jul;2(4):339–348. [PubMed] [Google Scholar]
  7. Paya C. V., Hermans P. E., Smith T. F., Rakela J., Wiesner R. H., Krom R. A., Torres V. E., Sterioff S., Wilkowske C. J. Efficacy of ganciclovir in liver and kidney transplant recipients with severe cytomegalovirus infection. Transplantation. 1988 Aug;46(2):229–234. doi: 10.1097/00007890-198808000-00008. [DOI] [PubMed] [Google Scholar]
  8. Saltzman R. L., Quirk M. R., Jordan M. C. High levels of circulating cytomegalovirus DNA reflect visceral organ disease in viremic immunosuppressed patients other than marrow recipients. J Clin Invest. 1992 Nov;90(5):1832–1838. doi: 10.1172/JCI116059. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Shabtai M., Luft B., Waltzer W. C., Anaise D., Rapaport F. T. Massive cytomegalovirus pneumonia and myocarditis in a renal transplant recipient: successful treatment with DHPG. Transplant Proc. 1988 Jun;20(3):562–563. [PubMed] [Google Scholar]
  10. Tomioka N., Kishimoto C., Matsumori A., Kawai C. Effects of prednisolone on acute viral myocarditis in mice. J Am Coll Cardiol. 1986 Apr;7(4):868–872. doi: 10.1016/s0735-1097(86)80349-7. [DOI] [PubMed] [Google Scholar]

Articles from Postgraduate Medical Journal are provided here courtesy of BMJ Publishing Group

RESOURCES