Skip to main content
SpringerLink
Log in

Schwerer klinischer Verlauf einer Myokarditis mit „apical ballooning“

Erstbeschreibung der Pathogenität von HHV6 Subtyp A bei Myokarditis

Serious clinical course of myocarditis with “apical ballooning”: first presentation of pathogenicity of HHV6 subtype A in myocarditis

  • Kasuistiken
  • Published:
Der Internist Aims and scope Submit manuscript

Zusammenfassung

Eine 67-jährige Patientin stellte sich 3 Tage nach grippalem Infekt mit Verdacht auf ein akutes Koronarsyndrom vor. Eine koronare Herzerkrankung konnte ausgeschlossen werden. Die Ventrikulographie zeigte eine mittelgradig reduzierte linksventrikuläre Funktion, charakterisiert durch „apical ballooning“. Im Blut und in den Herzmuskelbiopsien gelang der Nachweis von humanem Herpesvirus 6 (HHV6) Subtyp A. Histologisch und immunhistochemisch fand sich eine Myokarditis mit einer fokal vermehrten Anzahl von Makrophagen und einer interstitiellen Fibrose. Diese Kasuistik beschreibt erstmalig die Assoziation einer Myokarditis im Rahmen einer HHV6A-Infektion mit dem Auftreten eines „apical ballooning“.

Abstract

We report of a 67 year-old female who has suffered a flu-like infection three days ago and presented with symptoms of acute coronary syndrome. Coronary heart disease could be excluded. The ventriculography showed a moderate reduced left ventricular function characterized by “apical ballooning”. Endomyocardial biopsies and EDTA blood gave a direct proof of human herpes virus 6 subtype A. Histological and immunohistochemical analysis revealed a myocarditis with areas of interstitial macrophages and fibrosis. This case presents for the first time the cross-link of myocarditis with HHV6A infection and the appearance of “apical ballooning”.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Abb. 1
Abb. 2a, b
Abb. 3a, b
Abb. 4a, b
Abb. 5a, b
Abb. 6

Literatur

  1. Abe Y, Kondo M (2003) Apical ballooning of the left ventricle: a distinct entity? Heart 89: 974–976

    Article  PubMed  Google Scholar 

  2. Borghi E, Pagani E, Mancuso R et al. (2005) Detection of herpesvirus-6A in a case of subacute cerebellitis and myoclonic dystonia. J Med Virol 75: 427–429

    Article  PubMed  Google Scholar 

  3. Bybee KA, Kara T, Prasad A, Lerman A, Barsness GW, Wright RS, Rihal CS (2004) Systematic review: transient left ventricular apical ballooning: a syndrome that mimics ST-Segment elevation myocardial infarction. Ann Intern Med 141: 858–865

    PubMed  Google Scholar 

  4. Chan PK, Ng HK, Hui M, Cheng AF (2001) Prevalence and distribution of human herpesvirus 6 variants A and B in adult human brain. J Med Virol 64: 42–46

    Article  PubMed  Google Scholar 

  5. De Bolle L, Naesens L, De Clercq E (2005) Update on human herpesvirus 6 biology, clinical features, and therapy. Clin Microbiol Rev 18: 217–245

    Article  PubMed  Google Scholar 

  6. Freitas RB, Freitas MR, Linhares AC (2003) Evidence of active herpesvirus 6 (variant-A) infection in patients with lymphadenopathy in Belem, Para, Brazil. Rev Inst Med Trop Sao Paulo 45: 283–288

    PubMed  Google Scholar 

  7. Kandolf R (2004) Virusätiologie der inflammatorischen Kardiomyopathie. Dtsch Med Wochenschr 129: 2187–2192

    Article  PubMed  Google Scholar 

  8. Kurisu S, Sato H, Kawagoe T et al. (2002) Tako-tsubo-like left ventricular dysfunction with ST-segment elevation: a novel cardiac syndrome mimicking acute myocardial infarction. Am Heart J 143: 448–455

    Article  PubMed  Google Scholar 

  9. Mori Y, Seya T, Huang HL, Akkapaiboon P, Dhepakson P, Yamanishi K (2002) Human herpesvirus 6 variant A but not variant B induces fusion from without in a variety of human cells through a human herpesvirus 6 entry receptor, CD46. J Virol 76: 6750–6761

    Article  PubMed  Google Scholar 

  10. Stodberg T, Deniz Y, Esteitie N et al. (2002) A case of diffuse leptomeningeal oligodendrogliomatosis associated with HHV6 variant A. Neuropediatrics 33: 266–270

    Article  PubMed  Google Scholar 

Download references

Interessenkonflikt:

Der korrespondierende Autor versichert, dass keine Verbindungen mit einer Firma, deren Produkt in dem Artikel genannt ist, oder einer Firma, die ein Konkurrenzprodukt vertreibt, bestehen.

Author information

Authors and Affiliations

  1. Medizinische Klinik III, Eberhard-Karls-Universität Tübingen

    B. Bigalke, A. E. May, M. Beyer, T. Hövelborn & M. Gawaz

  2. Abteilung für Molekulare Pathologie des Instituts für Pathologie, Eberhard-Karls-Universität Tübingen

    K. Klingel & R. Kandolf

  3. Medizinische Klinik III, Eberhard-Karls-Universität, Otfried-Müller-Straße 10, 72076, Tübingen

    B. Bigalke

Authors
  1. B. Bigalke
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. K. Klingel
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. A. E. May
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. M. Beyer
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. T. Hövelborn
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. R. Kandolf
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. M. Gawaz
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to B. Bigalke.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Bigalke, B., Klingel, K., May, A.E. et al. Schwerer klinischer Verlauf einer Myokarditis mit „apical ballooning“. Internist 46, 1259–1264 (2005). https://doi.org/10.1007/s00108-005-1494-6

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00108-005-1494-6

Schlüsselwörter

Keywords

Search

Navigation