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Permanent link (DOI): https://doi.org/10.7939/R3599Z81K

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A systematic review of intravenous gamma globulin for therapy of acute myocarditis. Open Access

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Author or creator
Robinson, J. L.
Hartling, L.
Crumley, E.
Vandermeer, B.
Klassen, T. P.
Additional contributors
Subject/Keyword
internal medicine
angiology
cardiology
cardiac surgery
blood transfusion
Type of item
Journal Article (Published)
Language
English
Place
Time
Description
Background: Intravenous gamma globulin (IVGG) is commonly used in the management of acute myocarditis. The objective of this study was to systematically review the literature evaluating this practice. Methods: We conducted a comprehensive search (electronic databases, trials registries, conference proceedings, reference lists, contact with authors) to identify studies evaluating the use of IVGG in adults and children with a clinical or histologically proven diagnosis of myocarditis of possible viral etiology and symptoms of less than six months duration. Two reviewers independently screened the searches, applied inclusion criteria, and graded the evidence. Results: Results were described qualitatively; data were not pooled because only one randomized controlled trial (RCT) with 62 patients was identified. The RCT showed no benefit with respect to cardiac function, functional outcome, or event-free survival. A small, uncontrolled trial (n = 10) showed significant improvement in LVEF from a mean of 24% to 41% 12 months after IVGG in nine survivors. A retrospective cohort study of pediatric patients showed improvement in cardiac function and a trend towards improved survival in patients receiving IVGG (n = 21) versus historic controls (n = 25). Ten case reports and two case series (total n = 21) described improvement in cardiac function after administration of IVGG; two case reports showed no benefit of IVGG. One case of hemolytic anemia was attributed to IVGG. Conclusion: There is insufficient data from methodologically strong studies to recommend routine use of IVGG for acute myocarditis. Future randomized studies that take into account the etiology of acute myocarditis will be required to determine the efficacy of IVGG.
Date created
2005
DOI
doi:10.7939/R3599Z81K
License information
Creative Commons Attribution-Non-Commercial 3.0 Unported
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Citation for previous publication
Robinson, J. L., Hartling, L., Crumley, E., Vandermeer, B., & Klassen, T. P. (2005). A systematic review of intravenous gamma globulin for therapy of acute myocarditis. BMC Cardiovasc Disord, 5(1), 12. doi: 10.1186/1471-2261-5-12.
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