Efficacy and Safety of Intravenous Immunoglobulin (IVIg) in Acute Viral Myocarditis in Children: A Systematic Review of Randomized Controlled Trials.

CONTEXT: Acute myocarditis is a rare but potentially life-threatening condition in infants and children. While immunosuppressive agents have shown limited effectiveness, intravenous immunoglobulin (IVIg) holds promise as a treatment option.

OBJECTIVE

To study the efficacy and safety of intravenous immunoglobulin (IVIg) in treating acute viral myocarditis in children.

EVIDENCE ACQUISITION: We searched five databases including PubMed, EMBASE, the Cochrane Library, Scopus, and Web of Science; and four trial registries for published studies on the topic. Grey literature was searched through ProQuest and Open Grey databases. The studies eligible for this review were randomized controlled trials in children (< 18 years) with acute viral myocarditis (Population), comparing IVIg (Intervention), versus no IVIg i.e., any other treatment or placebo (Comparator), for efficacy and safety (Outcomes).

RESULTS

The literature search identified a total of 9,524 records. Two reviewers independently screened these records. A total of 73 citations were deemed potentially eligible, all of which were non-RCTs or review articles on full text examination. There were no RCTs identified to address the review question.

CONCLUSION

There are no RCTs in children comparing the efficacy and safety of IVIg treatment in acute viral myocarditis. Prospective randomized trials are urgently required.