Myocarditis in Duchenne Muscular Dystrophy After Changing Steroids

JAMA Cardiology
Abdul Rahman A AbutalebJane E Wilcox

Abstract

Cardiac dysfunction is a leading cause of morbidity and mortality in Duchenne muscular dystrophy (DMD). This case highlights the importance of steroids in treating cardiac complications of DMD and the dangers of discontinuing or switching between steroid classes. To recognize the presentation of acute myocardial inflammation, or dystrophinitis, in DMD, which presents as myocarditis and to treat the myocardial inflammation and dilated cardiomyopathy associated with DMD through guideline-directed medical therapy, steroids, and serial surveillance for cardiac dysfunction. A case report of an 18-year-old patient with DMD and with steroid withdrawal-induced myocarditis followed up for 3 years to observe for cardiac function recovery and the natural history of cardiomyopathy in DMD, who was hospitalized in the cardiac care unit and followed up between November 3, 2016, and March 27, 2017. Switching from deflazacort to underdosed prednisone for 7 days. Increased myocardial inflammation, edema, and fibrosis after stopping deflazacort abruptly. An 18-year-old male patient with DMD presented to the emergency department with acute-onset chest pain. Ischemic changes were present on electrocardiogram, and elevated cardiac enzymes were detec...Continue Reading

References

Jan 10, 2001·The Journal of Pediatrics·W D BiggarC A Steele
Mar 16, 2005·Journal of the American College of Cardiology·Denis DubocHenri-Marc Bécane
Aug 28, 2007·American Heart Journal·Denis DubocHenri-Marc Bécane
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Dec 1, 2009·Lancet Neurology·Katharine BushbyUNKNOWN DMD Care Considerations Working Group
Oct 7, 2017·Journal of Neuromuscular Diseases·Kan N HorLinda Cripe

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Citations

Nov 17, 2019·Current Treatment Options in Cardiovascular Medicine·Lewis Hahn, Seth Kligerman
Feb 9, 2021·Current Problems in Diagnostic Radiology·Felipe SanchezDaniel Vargas
May 22, 2021·Current Problems in Cardiology·Qingtong Wang Wei Wei

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