Online ISSN: 2187-2988 Print ISSN: 0911-1794
特定非営利活動法人日本小児循環器学会 Japanese Society of Pediatric Cardiology and Cardiac Surgery
Pediatric Cardiology and Cardiac Surgery 38(3): 172-177 (2022)

症例報告Case Report

重症筋無力症を合併した好酸球性心筋炎の幼児の一例An Infant Case of Eosinophilic Myocarditis with Myasthenia Gravis

榊原記念病院小児循環器科Department of Pediatric Cardiology, Sakakibara Heart Institute ◇ Tokyo, Japan

受付日:2021年11月15日Received: November 15, 2021
受理日:2022年5月19日Accepted: May 19, 2022
発行日:2022年8月1日Published: August 1, 2022


Eosinophilic myocarditis (EMC) is a myocardial disease with a benign prognosis, for which patients are successfully treated by the early administration of steroids. To date, no studies have reported the occurrence of myasthenia gravis (MG) during tapering of the steroid dose. A 3-year-old girl was admitted to our hospital with pallor and in respiratory distress, which were not associated with an antecedent infection. Echocardiography displayed depression of the wall motion. We suspected EMC because of eosinophilia and increased cardiac enzymes after the initial steroid therapy, so steroid treatment was restarted. The cardiac wall motion improved thereafter, with a decrease in peripheral blood eosinophilic count. After discharge from our hospital, she developed gait difficulty with muscle weakness and right blepharoptosis, and after detailed examination, she was diagnosed with MG. She was treated with immunosuppressants in addition to steroids, and her MG symptoms disappeared. Thus, it is important to administer steroids at the early phase when EMC was suspected. MG related to an immunological mechanism may occur because immunity is involved in the onset of EMC. This case suggests attending to neurological symptoms during tapering of the steroid dose.

Key words: eosinophilic myocarditis; hypereosinophilic syndrome; myasthenia gravis; predonisolone; giant thrombus

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