Human parechoviruses (HPeVs) are closely related to human enteroviruses and exhibit many similarities in disease spectrum and symptoms. HPeV1 is most commonly associated with mild disease, but rare associations with severe disease such as myocarditis have been reported. Currently, no treatment is available for severe HPeV infections. In this case report we describe an infant with a severe, dilated cardiomyopathy in whom HPeV1 was revealed to be the only identifiable cause. The infant was treated with intravenous immunoglobulins (IVIGs) and recovered completely. In vivo blood samples revealed a high HPeV1 antibody titer after treatment with IVIGs. In vitro IVIGs contained high titers of neutralizing antibodies against HPeV1. Our hypothesis is that patients with myocarditis caused by viruses with a high prevalence in the population and hence high antibody titers in IVIGs are likely to benefit from treatment with IVIGs. More research combining virological and clinical data is needed to see whether this hypothesis is true.
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July 2013
Case Report|
July 01 2013
Successful IVIG Treatment of Human Parechovirus-Associated Dilated Cardiomyopathy in an Infant
Joanne G. Wildenbeest, MD;
Departments of aPediatric Infectious Diseases and Immunology, and
bLaboratory of Clinical Virology, Department of Medical Microbiology, Academic Medical Center, Amsterdam, Netherlands
Address correspondence to Joanne G. Wildenbeest, MD, Department of Pediatric Infectious Diseases and Immunology, H7-270, Emma Children’s Hospital, Academic Medical Center, Postbus 22660, 1100 DD Amsterdam, The Netherlands. E-mail: j.g.wildenbeest@amc.uva.nl
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Katja C. Wolthers, MD;
Katja C. Wolthers, MD
bLaboratory of Clinical Virology, Department of Medical Microbiology, Academic Medical Center, Amsterdam, Netherlands
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Bart Straver, MD;
Bart Straver, MD
cPediatric Cardiology, Emma Children’s Hospital, Academic Medical Center, Amsterdam, Netherlands; and
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Dasja Pajkrt, MD
Dasja Pajkrt, MD
Departments of aPediatric Infectious Diseases and Immunology, and
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Address correspondence to Joanne G. Wildenbeest, MD, Department of Pediatric Infectious Diseases and Immunology, H7-270, Emma Children’s Hospital, Academic Medical Center, Postbus 22660, 1100 DD Amsterdam, The Netherlands. E-mail: j.g.wildenbeest@amc.uva.nl
FINANCIAL DISCLOSURE: The authors have indicated they have no financial relationships relevant to this article to disclose.
Pediatrics (2013) 132 (1): e243–e247.
Article history
Accepted:
March 11 2013
Citation
Joanne G. Wildenbeest, Katja C. Wolthers, Bart Straver, Dasja Pajkrt; Successful IVIG Treatment of Human Parechovirus-Associated Dilated Cardiomyopathy in an Infant. Pediatrics July 2013; 132 (1): e243–e247. 10.1542/peds.2012-1136
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