Myocarditis Induced by Immunotherapy: A Rare but Fatal Complication
P. M. Mulendele *
Department of Cardiology P37, Ibn Rochd University Hospital, Casablanca, Morocco.
M. Njie
Department of Cardiology P37, Ibn Rochd University Hospital, Casablanca, Morocco.
M. B. Charfo
Department of Cardiology P37, Ibn Rochd University Hospital, Casablanca, Morocco.
G. M. Lukifimpa
Hospital Centre of South Seine and Marne, NEMOURS, France.
M. S. Boutar
Department of Cardiology P37, Ibn Rochd University Hospital, Casablanca, Morocco.
B. E. Ovaga
Department of Cardiology P37, Ibn Rochd University Hospital, Casablanca, Morocco.
M. Haboub
Department of Cardiology P37, Ibn Rochd University Hospital, Casablanca, Morocco and Faculty of Medicine and Pharmacy, Hassan II University, Casablanca, Morocco.
S. Arous
Department of Cardiology P37, Ibn Rochd University Hospital, Casablanca, Morocco and Faculty of Medicine and Pharmacy, Hassan II University, Casablanca, Morocco.
M. G. Benouna
Department of Cardiology P37, Ibn Rochd University Hospital, Casablanca, Morocco and Faculty of Medicine and Pharmacy, Hassan II University, Casablanca, Morocco.
A. Drighil
Department of Cardiology P37, Ibn Rochd University Hospital, Casablanca, Morocco and Faculty of Medicine and Pharmacy, Hassan II University, Casablanca, Morocco.
L. Azzouzi
Department of Cardiology P37, Ibn Rochd University Hospital, Casablanca, Morocco and Faculty of Medicine and Pharmacy, Hassan II University, Casablanca, Morocco.
R. Habbal
Department of Cardiology P37, Ibn Rochd University Hospital, Casablanca, Morocco and Faculty of Medicine and Pharmacy, Hassan II University, Casablanca, Morocco.
*Author to whom correspondence should be addressed.
Abstract
The emergence of immunotherapy and the gradual expansion of its indications in oncology will require particular vigilance to detect and quickly take care of the potential cardiac toxicities. They have improved prognosis and survival, including patients with kidney, lung or skin cancers (melanoma) and certain lymphomas. The incidence of unwanted cardiac events under immunotherapy is rare, undoubtedly less than 1 % under Ipilimab, Pembrolizumab and Nivolumab. Cardiac toxicity can be induced by many drugs but this time we focused on myocarditis induced by immuno-modulators, which is a rare but very fatal complication and has 2 main parts: an illustration of a clinical case and a review of the literature comprising generality, pathophysiology, clinical manifestations, diagnostic strategy and therapeutic management based on the guidelines of the European Society of cardiology on cardio-oncology recently published in 2022. Corticosteroids are drugs effective in the treatment of cardiac toxicity induced by immunotherapy.
Keywords: Myocarditis, immune check point inhibitors, corticosteroids
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References
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