Skip to main content
NCBI home page
Journal of Clinical Pathology logoLink to Journal of Clinical Pathology
. 1990 Aug;43(8):650–653. doi: 10.1136/jcp.43.8.650

Calcium overload in human giant cell myocarditis.

H G Olbrich 1, G Herrmann 1, G Vandeplassche 1, H Michaelis 1, M Schneider 1, E Krause 1, G Kober 1
PMCID: PMC502647  PMID: 2401733

Abstract

Myocardial calcium overload was observed in a patient with giant cell myocarditis. The myocardial calcium content estimated by atomic absorption spectrophotometry amounted to 120 mEq/kg dry weight, and the von Kossa stain disclosed multiple foci with patchy calcifications of myocardial fibres. Cytochemical examination of the ultrastructural calcium localisation using the phosphate-pyroantimonate method showed considerable variation in the subcellular calcium distribution. In normal myocytes calcium precipitates were confined to the inner leaflet of the sarcolemma, T-tubules, intercalated disks, and sporadically to mitochondria. In contrast, extensive calcification of mitochondria and loss of sarcolemmal calcium was evident in necrotic myocytes. A number of grossly normal myocytes also showed an increase of calcium precipitates in slightly swollen mitochondria. These findings suggest that myocardial calcium overload in this case started in viable myocytes and was not merely a secondary phenomenon occurring after cell death.

Full text

PDF
650

Images in this article

652Image
on p.652
652Image
on p.652

Selected References

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

  1. Azuma J., Sperelakis N., Hasegawa H., Tanimoto T., Vogel S., Ogura K., Awata N., Sawamura A., Harada H., Ishiyama T. Adriamycin Cardiotoxicity: possible pathogenic mechanisms. J Mol Cell Cardiol. 1981 Apr;13(4):381–397. doi: 10.1016/0022-2828(81)90281-9. [DOI] [PubMed] [Google Scholar]
  2. BREAN H. P., MARKS J. H. Massive calcification in infarcted myocardium. Radiology. 1950 Jan;54(1):33-42, illust. doi: 10.1148/54.1.33. [DOI] [PubMed] [Google Scholar]
  3. Borgers M., Shu L. G., Xhonneux R., Thoné F., Van Overloop P. Changes in ultrastructure and Ca2+ distribution in the isolated working rabbit heart after ischemia. A time-related study. Am J Pathol. 1987 Jan;126(1):92–102. [PMC free article] [PubMed] [Google Scholar]
  4. Borgers M., Thone F. J., Xhonneux B. J., De Clerck F. F. Localization of calcium in red blood cells. J Histochem Cytochem. 1983 Sep;31(9):1109–1116. doi: 10.1177/31.9.6411806. [DOI] [PubMed] [Google Scholar]
  5. Borgers M., Thone F., Verheyen A., Ter Keurs H. E. Localization of calcium in skeletal and cardiac muscle. Histochem J. 1984 Mar;16(3):295–309. doi: 10.1007/BF01003613. [DOI] [PubMed] [Google Scholar]
  6. Cheung J. Y., Bonventre J. V., Malis C. D., Leaf A. Calcium and ischemic injury. N Engl J Med. 1986 Jun 26;314(26):1670–1676. doi: 10.1056/NEJM198606263142604. [DOI] [PubMed] [Google Scholar]
  7. DUKE M. Massive calcification of the myocardium of unknown origin. AMA Arch Pathol. 1957 Jul;64(1):34–38. [PubMed] [Google Scholar]
  8. Davies M. J., Pomerance A., Teare R. D. Idiopathic giant cell myocarditis--a distinctive clinico-pathological entity. Br Heart J. 1975 Feb;37(2):192–195. doi: 10.1136/hrt.37.2.192. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Farber J. L., Chien K. R., Mittnacht S., Jr Myocardial ischemia: the pathogenesis of irreversible cell injury in ischemia. Am J Pathol. 1981 Feb;102(2):271–281. [PMC free article] [PubMed] [Google Scholar]
  10. Ferrans V. J., Hibbs R. G., Walsh J. J., Burch G. E. Histochemical and electron microscopical studies on the cardiac necroses produced by sympathomimetic agents. Ann N Y Acad Sci. 1969 Jan 31;156(1):309–332. doi: 10.1111/j.1749-6632.1969.tb16737.x. [DOI] [PubMed] [Google Scholar]
  11. Flameng W., Xhonneux R., Van Belle H., Borgers M., Van de Water A., Wouters L., Wijnants J., Thoné F., Van Daele P., Janssen P. A. Cardioprotective effects of mioflazine during 1 h normothermic global ischaemia in the canine heart. Cardiovasc Res. 1984 Sep;18(9):528–537. doi: 10.1093/cvr/18.9.528. [DOI] [PubMed] [Google Scholar]
  12. Fleckenstein A., Janke J., Döring H. J., Leder O. Die intracelluläre Uberladung mit Kalzium als entscheidender Kausalfaktor bei der Entstehung nicht-coronarogener Myokard-Nekrosen. Verh Dtsch Ges Kreislaufforsch. 1971;37:345–353. [PubMed] [Google Scholar]
  13. HERMANN G., 3rd, HAUPT G. J., BIRKHEAD N. C. RAPID MYOCARDIAL CALCIFICATION AFTER CARDIAC SURGERY. JAMA. 1963 Oct 19;186:260–261. doi: 10.1001/jama.1963.63710030036021a. [DOI] [PubMed] [Google Scholar]
  14. Jasmin G., Eu H. Y. Cardiomyopathy of hamster dystrophy. Ann N Y Acad Sci. 1979;317:46–58. doi: 10.1111/j.1749-6632.1979.tb56509.x. [DOI] [PubMed] [Google Scholar]
  15. Laufer A., Davies A. M. Experimental granulomatous myocarditis: genesis and immunological aspects. Ann N Y Acad Sci. 1969 Jan 31;156(1):91–104. doi: 10.1111/j.1749-6632.1969.tb16720.x. [DOI] [PubMed] [Google Scholar]
  16. Lossnitzer K., Steinhardt B., Grewe N., Stauch M. Charakteristische Elektrolytveränderungen bei der erblichen Myopathie mit Kardiomyopathie des Syrischen Goldhamsters (Stamm BIO 8262) Basic Res Cardiol. 1975 Sep-Oct;70(5):508–520. doi: 10.1007/BF01906382. [DOI] [PubMed] [Google Scholar]
  17. Lüllmann H., Peters T. Plasmalemmal calcium in cardiac excitation-contraction coupling. Clin Exp Pharmacol Physiol. 1977 Jan-Feb;4(1):49–57. doi: 10.1111/j.1440-1681.1977.tb02377.x. [DOI] [PubMed] [Google Scholar]
  18. Olbrich H. G., Borgers M., Thoné F., Frotscher M., Mutschler E., Schneider M., Kober G., Kaltenbach M. Ultrastructural localization of calcium in the myocardium of cardiomyopathic syrian hamsters. J Mol Cell Cardiol. 1988 Aug;20(8):753–762. doi: 10.1016/s0022-2828(88)80019-1. [DOI] [PubMed] [Google Scholar]
  19. Pardo-Mindán F. J., Herreros J., Marigil M. A., Arcas R., Diez J. Myocardial calcification following heart transplantation. J Heart Transplant. 1986 Jul-Aug;5(4):332–335. [PubMed] [Google Scholar]
  20. Philipson K. D., Bers D. M., Nishimoto A. Y. The role of phospholipids in the Ca2+ binding of isolated cardiac sarcolemma. J Mol Cell Cardiol. 1980 Nov;12(11):1159–1173. doi: 10.1016/0022-2828(80)90063-2. [DOI] [PubMed] [Google Scholar]
  21. Pulford K. A., Rigney E. M., Micklem K. J., Jones M., Stross W. P., Gatter K. C., Mason D. Y. KP1: a new monoclonal antibody that detects a monocyte/macrophage associated antigen in routinely processed tissue sections. J Clin Pathol. 1989 Apr;42(4):414–421. doi: 10.1136/jcp.42.4.414. [DOI] [PMC free article] [PubMed] [Google Scholar]
  22. Pyun K. S., Kim Y. H., Katzenstein R. E., Kikkawa Y. Giant cell myocarditis. Light and electron microscopic study. Arch Pathol. 1970 Aug;90(2):181–188. [PubMed] [Google Scholar]
  23. Schultheiss H. P., Kühl U., Janda I., Melzner B., Ulrich G., Morad M. Antibody-mediated enhancement of calcium permeability in cardiac myocytes. J Exp Med. 1988 Dec 1;168(6):2105–2119. doi: 10.1084/jem.168.6.2105. [DOI] [PMC free article] [PubMed] [Google Scholar]
  24. Sekiguchi M., Numao Y., Imai M., Furuie T., Mikami R. Clinical and histopathological profile of sarcoidosis of the heart and acute idiopathic myocarditis. Concepts through a study employing endomyocardial biopsy. I. Sarcoidosis. Jpn Circ J. 1980 Apr;44(4):249–263. doi: 10.1253/jcj.44.249. [DOI] [PubMed] [Google Scholar]
  25. Tanaka M., Ichinohasama R., Kawahara Y., Esaki Y., Hirokawa K., Okishige K., Tanaka Y. Acute idiopathic interstitial myocarditis: case report with special reference to morphological characteristics of giant cells. J Clin Pathol. 1986 Nov;39(11):1209–1216. doi: 10.1136/jcp.39.11.1209. [DOI] [PMC free article] [PubMed] [Google Scholar]
  26. Terman D. S., Alfrey A. C., Hammond W. S., Donndelinger T., Ogden D. A., Holmes J. H. Cardiac calcification in uremia. A clinical, biochemical and pathologic study. Am J Med. 1971 Jun;50(6):744–755. doi: 10.1016/0002-9343(71)90182-3. [DOI] [PubMed] [Google Scholar]
  27. Theaker J. M., Gatter K. C., Brown D. C., Heryet A., Davies M. J. An investigation into the nature of giant cells in cardiac and skeletal muscle. Hum Pathol. 1988 Aug;19(8):974–979. doi: 10.1016/s0046-8177(88)80015-7. [DOI] [PubMed] [Google Scholar]
  28. Tubbs R. R., Sheibani K., Hawk W. A. Giant cell myocarditis. Arch Pathol Lab Med. 1980 May;104(5):245–246. [PubMed] [Google Scholar]
  29. WHITEHEAD R. ISOLATED MYOCARDITIS. Br Heart J. 1965 Mar;27:220–230. doi: 10.1136/hrt.27.2.220. [DOI] [PMC free article] [PubMed] [Google Scholar]
  30. Wheeler-Clark E. S., Tormey J. M. Electron probe x-ray microanalysis of sarcolemma and junctional sarcoplasmic reticulum in rabbit papillary muscles: low sodium-induced calcium alterations. Circ Res. 1987 Feb;60(2):246–250. doi: 10.1161/01.res.60.2.246. [DOI] [PubMed] [Google Scholar]

Articles from Journal of Clinical Pathology are provided here courtesy of BMJ Publishing Group

RESOURCES