Crohn's colitis-induced myocarditis

Belin, Rashad J.; Ghasemiesfe, Ahmadreza; Carr, James; Miller, Frank H.; Parada, Carolina; Akhter, Nausheen

doi:10.1016/j.jccase.2016.03.007

Cited by 7 publications

(6 citation statements)

References 9 publications

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“…In our patient, the use of multi-modality imaging CMRI and FDG PET led us to the diagnosis of Crohn's diseases with perimyocarditis as an extra-intestinal manifestation. To our knowledge, this is also the first case presentation reporting the use of FGD PET Scan and multimodality imaging in diagnosing acute perimyocarditis due to underlying Crohn's disease [7,[15][16][17][18].…”

Section: Discussionmentioning

confidence: 77%

“…Myocarditis is a rare extra-intestinal manifestation in Crohn's disease, with a reported prevalence of 0.04 %, and can occur in patients between 20 and 50 years old [1,[5][6][7][8]. Patients can present with a variety of symptoms ranging from mild symptoms to cardiogenic shock with high mortality risk [4].…”

Section: Discussionmentioning

confidence: 99%

“…While the pathophysiology of perimyocarditis in Crohn's disease remains uncertain [2,5], there are two possible pathogenic mechanisms. Firstly, it may be immune mediated resulting from genetic susceptibility, abnormal self-recognition, and autoantibodies against specific cellular antigens shared by the gastrointestinal tract and myocardium or pericardium [9].…”

Section: Discussionmentioning

confidence: 99%

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The role of multimodality imaging in diagnosing acute perimyocarditis secondary to Crohn’s disease

Prameswari

Balakrishnan

Khoo

et al. 2021

BMC Cardiovasc Disord

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Background Acute perimyocarditis is a rare extra-intestinal manifestation in Crohn’s disease which required multimodality imaging to confirm the diagnosis. Here we present a case of acute perimyocarditis as the first presentation of Crohn’s disease. To date, this is the first case presentation reporting the use of 18F-FDG PET/CT Scan for diagnosing such condition. Case presentation A 25-year-old male presented to our hospital with severe persistent pleuritic sharp left-sided chest pain. This was his second hospital admission in the past 4 months for chest pain and diarrhea. At the first hospitalization, he was diagnosed with viral perimyocarditis and irritable bowel syndrome. Laboratory findings, electrocardiogram, and cardiac magnetic resonance imaging results confirm the diagnostic of perimyocarditis. Virology, bacteriology, parasitology, and autoimmune evaluations were unremarkable. Colonoscopy, colorectal biopsy, and 18FGD PET findings confirmed manifestation of perimyocarditis, Crohn’s disease, and negative for sarcoidosis. Conclusions Looking at the overall clinical picture and investigation results of colonoscopy, colorectal biopsy findings, as well as multi-modality imaging with echocardiography, 18FDG PET—scan and CMRI, the patient was diagnosed to have perimyocarditis attending Chron’s disease flare up as a rare extra-intestinal manifestation.

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Section: Discussionmentioning

confidence: 77%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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The role of multimodality imaging in diagnosing acute perimyocarditis secondary to Crohn’s disease

Prameswari

Balakrishnan

Khoo

et al. 2021

BMC Cardiovasc Disord

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“…After ruling out obstructive coronary disease, that patient improved with conservative management and naproxen. Similar episodes of myopericarditis have been shown to occur in conjunction with viral infections [17], certain medications [18], connective tissue diseases [19], or inflammatory bowel disease [20]. Viruses shown to be more common in having cardiotropic effects include Coxsackieviruses, adenoviruses, cytomegaloviruses, echovirus, influenza, Epstein Barr, Human Herpes Virus 6, Hepatitis C, and parvovirus B19 [21][22].…”

Section: Discussionmentioning

confidence: 93%

A concurrent presentation of nonspecific colitis as well as likely myocarditis

et al. 2018

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An ST-segment elevation myocardial infarction represents a time-sensitive cardiac pathology with utmost importance placed upon timely coronary angiography with percutaneous coronary intervention. While emphasis is placed on atherosclerotic or thrombotic coronary occlusion, it is important to recognize other etiologies which may present in a similar fashion. This case demonstrates a 71-year-old female patient with prior coronary artery disease and stenting who presented with acute abdominal pain and elevated cardiac biomarkers as well as ST-segment elevation on initial EKG. Coronary angiography revealed only mild to moderate coronary lesions and patent stents while echocardiography was essential unchanged from prior evaluation. Computed tomography of the abdomen would show findings suggestive of infectious colitis and empiric antibiotics led to full resolution of symptoms. While no definitive cause for her cardiac manifestations was discovered, the authors propose coronary vasospasm or myo-pericarditis as likely etiologies in response to an overwhelming inflammatory state. The case underscores the importance of formulating a comprehensive differential diagnosis during the initial workup of a ST-segment elevation myocardial infarction.

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“…A study on adults reported CD-induced myocarditis occurring secondary to acute flares of Crohn’s colitis, and the use of solumedrol and infliximab improved the patients’ conditions [ 16 ]. Oh et al reported a case wherein myocarditis was diagnosed several weeks before the diagnosis of CD.…”

Section: Discussionmentioning

confidence: 99%

Diagnosis of Concomitant Myocarditis in a 13-Year-Old Patient with Crohn’s Disease

Kim

2022

Children

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Extraintestinal manifestations (EIMs) of inflammatory bowel disease (IBD) are diverse; however, cardiac manifestations are rare. Herein, we report a case of myocarditis associated with Crohn’s disease (CD) in a 13-year-old boy. The patient was hospitalized for an evaluation of IBD due to recurrent abdominal pain and diarrhea for several months. On the second day of hospitalization, the patient complained of shortness of breath and chest discomfort. Chest radiography revealed cardiomegaly and pulmonary edema with sinus tachycardia on electrocardiogram (ECG). Echocardiography revealed slight right ventricular (RV) dysfunction and mild left ventricular (LV) dilatation. Laboratory results revealed elevated levels of cardiac markers and soluble suppression of tumorigenicity (sST2), both of which indicated fulminant myocarditis. The patient was diagnosed with acute myocarditis and treated in the intensive care unit, where he had massive and intermittent episodes of bloody stools. Several studies for the diagnosis of IBD were continued after the patient improved. Additional capsule endoscopy revealed multiple ulcers with active bleeding in the small intestine. Therefore, CD with small intestine involvement was diagnosed. This is the first reported case of myocarditis co-occurring as an EIM in pediatric CD. The occurrence of myocarditis in IBD and gastrointestinal bleeding are considered to be related to vasculitis.

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Crohn's colitis-induced myocarditis

Cited by 7 publications

References 9 publications

The role of multimodality imaging in diagnosing acute perimyocarditis secondary to Crohn’s disease

The role of multimodality imaging in diagnosing acute perimyocarditis secondary to Crohn’s disease

A concurrent presentation of nonspecific colitis as well as likely myocarditis

Diagnosis of Concomitant Myocarditis in a 13-Year-Old Patient with Crohn’s Disease

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