Acute florid myocarditis treated by interferon-α -: A case report

Myocarditis-"the illness with many faces"- is still full of controversies. One of the biggest frustrations is: does interferon-a heal it, or aggravate it? The patient was an 18-year old boy with chest pain, as the solitary symptom. The pain was furious. Few days before boy had flu -like-syndrome. He was admitted for urgent coronary angiography. The invasive diagnostic procedure showed completely normal morphology of coronary artery vessels. In next 5 days the cardiospecific enzymes, ECG and ECHO sonography worsened progressively: troponin I raised ten times, creatine kinase also (CPK=857 U/1-->42442-->1358 U/1) followed by CK-MB isoenzimes by more than 10%. ECG became enormously bizarre. ECHO revealed the 8 mm pericardial effusion. Roferon A was introduced (1.5 million/24h sc). Laboratory data improved immediately. ECG returned to normal. The boy was discharged 7 days later. Roferon A therapy continued for the next 3 weeks. Six month follow-up showed normal clinical and lab data. Currently, there are no exact recommendations how to treat myocarditis.