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Focus on Autoimmune Myocarditis in Graves' Disease: A Case-Based Review

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单位: [1]Division of Cardiology,Department of Internal Medicine,Tongji Medical College,Tongji Hospital,Huazhong University ofScience and Technology,Wuhan,China [2]Hubei Key Laboratory of Genetics and Molecular Mechanism of CardiologicDisorders, Huazhong University of Science and Technology, Wuhan, China [3]Nursing Teaching Office of Internal Medicine,Tongji Hospital Affiliated to Tongji Medical College of Huazhong University of Science & Technology,Wuhan,China
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关键词: Graves' disease thyrotoxicosis autoimmune myocarditis cMRI glucocorticoid

摘要:
The manifestations of hyperthyroidism-related myocardial damage are multitudinous, including arrhythmia, dilated cardiomyopathy, valvular diseases, and even cardiogenic shock. Acute myocarditis induced by thyrotoxicosis had been reported in a few studies. However, attention on its prevalence and underlying mechanisms is sorely lacking. Its long-term harm is often ignored, and it may eventually develop into dilated cardiomyopathy and heart failure. We report a case of Graves' disease with a progressive elevation of hypersensitive cardiac troponin-I at several days after discontinuation of the patient's anti-thyroid drugs. Cardiac magnetic resonance imaging (CMRI) showed inflammatory edema of some cardiomyocytes (stranded enhanced signals under T2 mapping), myocardial necrosis (scattered enhanced signals under T1 late gadolinium enhancement) in the medial and inferior epicardial wall, with a decreased left ventricular systolic function (48%), which implied a possibility of acute myocarditis induced by thyrotoxicosis. The patient was then given a transient glucocorticoid (GC) treatment and achieved a good curative effect. Inspired by this case, we aim to systematically elaborate the pathogenesis, diagnosis, and treatment of hyperthyroidism-induced autoimmune myocarditis. Additionally, we emphasize the importance of CMRI and GC therapy in the diagnosis and treatment of hyperthyroidism-related myocarditis.

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出版当年[2020]版:
大类 | 2 区 医学
小类 | 3 区 心脏和心血管系统
最新[2025]版:
大类 | 3 区 医学
小类 | 3 区 心脏和心血管系统
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出版当年[2019]版:
Q2 CARDIAC & CARDIOVASCULAR SYSTEMS
最新[2023]版:
Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

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第一作者单位: [1]Division of Cardiology,Department of Internal Medicine,Tongji Medical College,Tongji Hospital,Huazhong University ofScience and Technology,Wuhan,China [2]Hubei Key Laboratory of Genetics and Molecular Mechanism of CardiologicDisorders, Huazhong University of Science and Technology, Wuhan, China
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通讯机构: [1]Division of Cardiology,Department of Internal Medicine,Tongji Medical College,Tongji Hospital,Huazhong University ofScience and Technology,Wuhan,China [2]Hubei Key Laboratory of Genetics and Molecular Mechanism of CardiologicDisorders, Huazhong University of Science and Technology, Wuhan, China
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