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KMID : 0882420080740000174
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Korean Journal of Medicine
2008 Volume.74 No. 0 p.174 ~ p.178
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A case of giant cell myocarditis with coronary atherosclerosis presenting as a sudden syncopal episode
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Kang Gu-Hyum
Kang Gu-Hyun
Kang Dae-Young
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Abstract
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Giant cell myocarditis (GCM) is an inflammatory heart disease characterized by granulomatous reaction with multinucleated giant cells. A 46-year-old man was transferred to the emergency department after eating a full meal of pufferfish prepared by a certified chef. He subsequently died. Postmortem toxicological study results were negative. Grossly, the heart was enlarged, weighing 655 g. There were numerous white patches throughout the epi- and myocardium. The coronary arteries also revealed severe atherosclerotic changes. Microscopically, extensive fibrosis and multiple exuberant granulomas were seen, with scattered multinucleated giant cells. Lymphocytes and eosinophils were also frequently found around the granulomatous lesions. Although GCM is a rare and frequently fatal disorder, recent studies suggest that combined immunosuppressive therapy may improve prognosis, and early referral for cardiac transplantation should be considered. (Korean J Med 74:S174-S178, 2008)
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KEYWORD
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Myocarditis, Coronary atherosclerosis, Sudden cardiac death
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