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. 2022 Aug 26;12(1):80.
doi: 10.1186/s13613-022-01054-0.

Anakinra in pediatric acute fulminant myocarditis

Louise Maunier  1 , Ramy Charbel  1 , Virginie Lambert  2   3 , Pierre Tissières  4   5 ; CLOVIS study group
Collaborators, Affiliations

Anakinra in pediatric acute fulminant myocarditis

Louise Maunier et al. Ann Intensive Care. .

Abstract

Background: Acute fulminant myocarditis in children is associated with elevated mortality and morbidity with few advances in its medical management. Here we report a preliminary experience of children treated with IL-1 receptor antagonist associated with rapid myocardial function recovery.

Methods: A retrospective case series of children admitted in the Pediatric Intensive Care Unit of the Bicêtre Hospital (AP-HP Paris Saclay University) between April 2020 and January 2022 with acute myocarditis. Children were treated with subcutaneous anakinra (an IL-1 receptor antagonist). Patients characteristics, and outcome are reported.

Results: Of 10 children admitted with acute fulminant myocarditis, eight were treated with sub-cutaneous anakinra. Seven children had SARS-CoV-2 post-infective myocarditis associated with multisystem inflammatory syndrome in children (MIS-C) and one child Parvovirus B19 myocarditis. In all patients a rapid (< 24 h) improvement in myocardial function was observed with concomitant decrease in myocardial enzymes. All patients survived with full myocardial recovery.

Conclusions: In this pilot study, use of IL-1 receptor antagonist in the initial treatment of acute fulminant myocarditis in children seems to be associated with rapid stabilization and recovery.

Keywords: Anakinra; B19 parvovirus; COVID-19; Children; IL-1 receptor antagonist; MIS-C; Myocarditis; PIMS–TS.

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Conflict of interest statement

All authors disclose any competing interest related to the manuscript.

Figures

Fig. 1
Fig. 1
Left ventricle ejection fraction and serum troponin T following anakinra therapy. Values are expressed as LVEF (%) at days 0–2, days 3–6, and days 7–15 after Anakinra therapy. Wilcoxon sign rank test was used to test paired values. LVEF, Left Ventricle Ejection Fraction; TnT, Troponin T
See this image and copyright information in PMC

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