International journal of cardiology · 2025
Interferon-beta and corticosteroid therapy for parvovirus B19 myocarditis in children.
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Gran Ferran, Dolader Paola, Juzga-Corrales Diana Carolina, Esmel-Vilomara Roger, Betrian Pedro, Escudero Fuensanta, Sorli Moisés, Melendo Susana, Garrido-Pontnou Marta, Navarro Alexandra, Camacho Jessica, Izquierdo-Blasco Jaume, Daina Carla, Escribà Silvia, Fernández-Polo Aurora, Luis-Garcia Maite, Vera Elena, Martin-Talavera Maria
Аннотация
BACKGROUND: Parvovirus B19 (PVB19) is a leading cause of acute myocarditis in children and carries a high risk of mortality or the need for cardiac transplantation. While interferon-beta (IFN-β) has demonstrated modest improvement in adult patients with dilated cardiomyopathy associated with PVB19 infection, clinical experience in pediatric populations remains limited. The objective of this study is to present our clinical experience with IFN-β and corticosteroids in pediatric patients with PVB19 myocarditis.
METHODS: A prospective cohort study was conducted for 9 years (from May 2015 to September 2024), including pediatric patients diagnosed with PVB19-myocarditis who were treated with a combination of IFN-β and steroids. The diagnosis was confirmed by endomyocardial biopsy (EMB).
RESULTS: A total of 12 patients with 13 episodes of PVB19-myocarditis were treated with a combination of IFN-β and steroids for six months. The median age was 16 months (9.5-31.5), and 50 % were male. Four patients were on extracorporeal membrane oxygenation (ECMO) when treatment commenced. All diagnoses were confirmed by EMB. After 2 weeks receiving IFN-β and corticosteroid therapy, all patients demonstrated clinical and echocardiographic improvement. Complete recovery was achieved in all of them after a median of 59 days (IQR 158.5), post-treatment initiation.
CONCLUSIONS: Our findings suggest that the combination of IFN-β and corticosteroids could improve outcomes in pediatric patients with this disease. This approach should be considered for patients with severe presentation, incomplete recovery or limited improvement. Multicenter studies are warranted to validate these results and establish definitive guidelines for the management of PVB19-myocarditis.
METHODS: A prospective cohort study was conducted for 9 years (from May 2015 to September 2024), including pediatric patients diagnosed with PVB19-myocarditis who were treated with a combination of IFN-β and steroids. The diagnosis was confirmed by endomyocardial biopsy (EMB).
RESULTS: A total of 12 patients with 13 episodes of PVB19-myocarditis were treated with a combination of IFN-β and steroids for six months. The median age was 16 months (9.5-31.5), and 50 % were male. Four patients were on extracorporeal membrane oxygenation (ECMO) when treatment commenced. All diagnoses were confirmed by EMB. After 2 weeks receiving IFN-β and corticosteroid therapy, all patients demonstrated clinical and echocardiographic improvement. Complete recovery was achieved in all of them after a median of 59 days (IQR 158.5), post-treatment initiation.
CONCLUSIONS: Our findings suggest that the combination of IFN-β and corticosteroids could improve outcomes in pediatric patients with this disease. This approach should be considered for patients with severe presentation, incomplete recovery or limited improvement. Multicenter studies are warranted to validate these results and establish definitive guidelines for the management of PVB19-myocarditis.