Table 1.
Summary of the included studies.
| Study (year) | Study design | Diagnosis | Sample size (IVIG/Non-IVIG) |
IVIG regimen | Author’s conclusion |
|---|---|---|---|---|---|
| Heidendael, Den Boer et al.17 | Retrospective cohort study | Biopsy-proven or clinically diagnosed viral myocarditis or dilated cardiomyopathy due to viral infection | 94 children: 21/73 | 2 g/kg |
New onset dilated cardiomyopathy (either viral or idiopathic origin) ◎ Did not influence transplant-free survival ◎ Better improvement in LVEF ◎ Better recovery |
| Butts, Boyle et al.26 | Retrospective cohort study | Newly confirmed myocarditis and clinically diagnosed myocarditis | 55 children: 44/11 | No dosing data |
◎ Not associated with mortality ◎ Not associated with heart transplantation, shortening fraction at discharge |
| Matsuura, Ichida et al.4 | Nationwide survey |
Biopsy-proven in 19.2% of cases Acute myocarditis (65.6%), Fulminant myocarditis (33.5%) |
237 children: 142/75 | No dosing data |
◎ Not affect the survival in the whole study population ◎ Better survival in fulminant myocarditis subgroup |
| Yen, Huang et al.19 | Retrospective cohort study | Culture-confirmed enterovirus infection, Clinical evident myocarditis | 15 neonate: 7/8 | 2–2.5 g/kg |
In defined severe neonatal enterovirus infections ◎ Beneficial for survival |
| Prasad and Chaudhary18 | Retrospective cohort study | Clinically diagnosed acute myocarditis | 28 children: 12/16 | 1 g/kg/day (for 2 days) |
◎ Beneficial for survival ◎ Improved recovery of LVEF ◎ Reduction in the episodes of fulminant arrhythmias |
| Bhatt, Sankar et al.20 | Quasi-randomized control study | Acute encephalitis syndrome complicated by clinically diagnosed myocarditis | 83 children: 26/57 | 400 mg/kg/day (for 5 days) |
Children with AES complicated by myocarditis ◎ Beneficial for survival ◎ Improved recovery of LVEF |
| Ghelani, Spaeder et al.5 | Retrospective cohort study | Biopsy-proven or MRI diagnosed acute myocarditis | 514 children: 359/155 | No dosing data | ◎ No difference in transplant-free survival |
| Saji, Matsuura et al.25 | Nationwide survey |
1 Biopsy-proven in 33.1% of cases 2 Acute myocarditis (58%), Fulminant myocarditis (42%) |
44 children: 29/15 | 1–2 g/kg/day (for 1–2 days) | ◎ No difference in survival |
| Klugman, Berger et al.27 | Retrospective cohort study | Clinically diagnosed myocarditis | 216 children: 98/118 | No dosing data | ◎ No difference in survival |
| Kim, Yoo et al.28 | Retrospective cohort study | Clinically diagnosed myocarditis | 33 children: 23/10 | 2 g/kg |
◎ No difference in recovery of LVEF ◎ No difference in survival |
| Haque, Bhatti et al.21 | Retrospective cohort study | Clinically diagnosed myocarditis | 25 children: 12/13 | 2 g/kg/day (for 1 day) |
◎ No difference in recovery of LVEF ◎ Beneficial for survival |
| English, Janosky et al.24 | Retrospective cohort study | Biopsy-proven or clinically diagnosed viral myocarditis | 34 children: 18/16 |
16 patients: 2 g/kg patients: 1 g/kg |
◎ No difference in time to recovery of normal LVEF ◎ No difference in survival |
| Drucker, Colan et al.16 | Retrospective cohort study | Biopsy-proven or clinically diagnosed viral myocarditis | 46 children: 21/25 | 2 g/kg/day (for 1 day) |
◎ Improved recovery of LVEF ◎ Better survival |
IVIG: intravenous immunoglobulin, LVEF: left ventricular ejection fraction.