Which systemic illnesses are associated with giant cell myocarditis in dilated cardiomyopathy?

Updated: Nov 28, 2018
  • Author: Vinh Q Nguyen, MD; Chief Editor: Gyanendra K Sharma, MD, FACC, FASE  more...
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Answer

Giant cell myocarditis is a rare condition usually associated with systemic illnesses such as the following:

  • Infections (eg, tuberculosis, endocarditis, fungi, syphilis, leprosy)

  • Rheumatologic illnesses (eg, rheumatoid arthritis, lupus, vasculitides, polymyositis, dermatomyositis)

  • Gastrointestinal conditions (eg, Crohn disease, ulcerative colitis, chronic hepatitis)

  • Autoantibody-associated conditions (eg, myasthenia gravis, Hashimoto thyroiditis)

  • Sarcoidosis

Giant cell myocarditis is often associated with conduction abnormalities and may progress rapidly. Necrotizing or nonnecrotizing granulomas are found, often with eosinophilia. T-cell infiltrates have been documented, and anti-CD3 antibody therapy may be effective. The idiopathic type is most often progressive and may require cardiac transplantation. Patients are usually young and present with heart failure or ventricular arrhythmias.


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