A Rare Case of Dilated Cardiomyopathy, Focal Segmental Glomerulosclerosis, and Bell’s Palsy in a 29-Year-Old Male After Coxsackievirus Infection

Abstract

Dilated cardiomyopathy (DCM) is a severe myocardial disease with diversified etiologies. Coxsackievirus serotype B (CV-B) is a known cause of infectious myocarditis that leads to DCM. The pathogenesis of CV-B myocarditis is complex and involves a combination of tissue destruction from viral proliferation and host immune response. Diagnosis is based on clinical findings and the presence of post-infection elevated titers of IgM antibodies to CV-B. Echocardiography is an important imaging modality that plays a key role in diagnosing DCM. Rare complications of coxsackievirus infection may include facial paralysis and chronic kidney disease with nephrotic syndrome. Here we present a rare case of a 29-year-old-male with recent Bell's palsy who presented with new-onset heart failure with left ventricular ejection fraction of 5% and focal segmental glomerulosclerosis nephrotic syndrome in the setting of elevated antibodies to CV-B.

Vaccines against Group B Coxsackieviruses and Their Importance

“…Thus, viral signatures may be the only readouts to determine their associations. In these scenarios, serologically, CVB-reactive antibodies are found in ~50% of DCM patients, while enterovirus genomic material can be detected in up to 70% [ 72 , 73 , 74 , 75 , 76 , 77 , 78 , 79 , 80 , 81 , 82 ], suggesting that CVB can be an important trigger of myocarditis/DCM, which may involve autoimmune responses to cardiac antigens [ 31 ].…”