Rare Case of Acute Myocarditis Complicating Macrophagic Activation Syndrome: A Complex Clinical Conundrum
Published: 2024-06-21
Page: 79-86
Issue: 2024 - Volume 7 [Issue 1]
Anass El Mokri El Mghari *
Department of Cardiology, Ibn Rochd University Hospital, Casablanca, Morocco.
Afaf Elmouhdi
Department of Cardiology, Ibn Rochd University Hospital, Casablanca, Morocco.
Meriem Tabat
Department of Cardiology, Ibn Rochd University Hospital, Casablanca, Morocco.
Mohammed Megzari
Department of Cardiology, Ibn Rochd University Hospital, Casablanca, Morocco.
Abdessamad Asklou
Department of Cardiology, Ibn Rochd University Hospital, Casablanca, Morocco.
Salim Arous
Faculty of Medicine and Pharmacy of Casablanca, Morocco.
Abdenasser Drighil
Faculty of Medicine and Pharmacy of Casablanca, Morocco.
Rachida Habbal
Faculty of Medicine and Pharmacy of Casablanca, Morocco.
*Author to whom correspondence should be addressed.
Abstract
Macrophagic Activation Syndrome (MAS) and myocarditis individually pose significant challenges to healthcare providers due to their complex pathophysiology and diverse clinical presentations. However, when these two conditions intersect, the immune system's dysregulation amplifies the inflammatory response, posing unique diagnostic and therapeutic dilemmas. The clinical presentation is nonspecific, showing no pathognomonic signs, the patient may present chest pain, shortness of breath, fever and signs of systemic inflammation, which calls for heightened awareness and a comprehensive approach to make the diagnosis and for better management.
In the following paper, we report the case of a 23 years old man admitted to our hospital for dyspnea, and chest pain, associated to an altered general condition and fever, and in whom, a constellation of clinical features and laboratory findings, met the diagnostic criteria for MAS associated to a myocarditis. He was treated with high dose intravenous corticosteroid, and heart failure drugs, resulting in resolution of fever and dramatic clinical improvement.
Keywords: Hyperferritinemia, cytokine release storm, corticosteroid, myocarditis, macrophage activation syndrome (MAS)