Morphological and immunogistochemical characteristics of myocardial damage in miastenia
https://doi.org/10.18087/cardio.2022.2.n1193
Abstract
The article presents a rare clinical case of a 45-year-old patient with generalized myasthenia with damages to the muscular apparatus of the extremities and the heart. A special feature of the case was myocardial damage evident as alterative-productive interstitial myocarditis with a peculiar immune phenotype of cell infiltrate, Cd3+, Cd4+, Cd8–, Cd68+. Furthermore, Cd68-expressing cells were presented by large macrophages with cytoplasmic granulation, which surrounded damaged cardiomyocytes. Around sites of cardiomyocyte alteration there were manifestations of neoangiogenesis with signs of Cd34 protein expression in thin-wall, capillary type blood vessels. These morphological and immunohistochemical changes in the myocardium supplement the concept of myasthenia morphogenesis.
Supporting agencies: No conflict of interest is reported.
About the Authors
S. S. Todorov
Rostov State Medical University, Rostov-on-Don
Russian Federation
Russian Federation
Head of the morphological department of the Rostov State Medical University, pathologist of the highest category, doctor of medical sciences
V. J. Deribas
Rostov State Medical University, Rostov-on-Don
Russian Federation
Russian Federation
Head of the Pathology Department, Assistant of the Department of Pathological Anatomy, Rostov State Medical University, Pathologist of the highest category
A. S. Kazmin
Rostov State Medical University, Rostov-on-Don
Russian Federation
Russian Federation
Assistant, Department of Pathological Anatomy, Rostov State Medical University, pathologist of the highest category
S. S. Todorov (jr)
Rostov State Medical University, Rostov-on-Don
Russian Federation
Russian Federation
student of the medical and preventive faculty of Rostov State Medical University
References
1. Helgeland G, Luckman SP, Romi FR, Jonassen AK, Gilhus NE. Myasthenia gravis sera have no effect on cardiomyocytes in vitro. Journal of Neuroimmunology. 2008;201–202:74–9. DOI: 10.1016/j.jneuroim.2008.05.021
2. Suzuki S, Baba A, Kaida K, Utsugisawa K, Kita Y, Tsugawa J et al. Cardiac involvements in myasthenia gravis associated with anti-Kv1.4 antibodies. European Journal of Neurology. 2014;21(2):223–30. DOI: 10.1111/ene.12234
3. Romi F, Skeie GO, Gilhus NE, Aarli JA. Striational Antibodies in Myasthenia Gravis: Reactivity and Possible Clinical Significance. Archives of Neurology. 2005;62(3):442–6. DOI: 10.1001/archneur.62.3.442
4. Suzuki S, Utsugisawa K, Yoshikawa H, Motomura M, Matsubara S, Yokoyama K et al. Autoimmune Targets of Heart and Skeletal Muscles in Myasthenia Gravis. Archives of Neurology. 2009;66(11):1334–8. DOI: 10.1001/archneurol.2009.229
5. Sasaki H, Yano M, Kawano O, Hikosaka Y, Fujii Y. Thymoma associated with fatal myocarditis and polymyositis in a 58-year-old man following treatment with carboplatin and paclitaxel: A case report. Oncology Letters. 2012;3(2):300–2. DOI: 10.3892/ol.2011.501
6. Kon T, Mori F, Tanji K, Miki Y, Kimura T, Wakabayashi K. Giant cell polymyositis and myocarditis associated with myasthenia gravis and thymoma: Giant cell polymyositis and myocarditis. Neuropathology. 2013;33(3):281–7. DOI: 10.1111/j.1440-1789.2012.01345.x
7. Joudinaud TM, Fadel E, Thomas-de-Montpreville V, Mussot S, Flecher EM, Dartevelle PG. Fatal giant cell myocarditis after thymoma resection in myasthenia gravis. The Journal of Thoracic and Cardiovascular Surgery. 2006;131(2):494–5. DOI: 10.1016/j.jtcvs.2005.09.035
8. Wong CP, Chia PL. Recurrent takotsubo cardiomyopathy precipitated by myasthenic crisis. International Journal of Cardiology. 2012;155(1):e11–2. DOI: 10.1016/j.ijcard.2011.06.129
9. Shivamurthy P, Parker MW. Cardiac manifestations of myasthenia gravis: A systematic review. IJC Metabolic & Endocrine. 2014;5:3–6. DOI: 10.1016/j.ijcme.2014.08.003
Review
For citations:
Todorov S.S., Deribas V.J., Kazmin A.S., Todorov (jr) S.S. Morphological and immunogistochemical characteristics of myocardial damage in miastenia. Kardiologiia. 2022;62(2):47-51. (In Russ.) https://doi.org/10.18087/cardio.2022.2.n1193
Views:
1025
Email this article 
Post a Comment 
