# Pediatric Myocarditis Management With Dual Immunotherapy: A Case Report Highlighting IVIG and Methylprednisolone Efficacy

## TL;DR

A 12-month-old girl with acute myocarditis showed significant improvement after treatment with IVIG and methylprednisolone, suggesting these therapies may be effective in pediatric cases.

## Contribution

This case report highlights the potential efficacy of combining IVIG and methylprednisolone in treating acute pediatric myocarditis.

## Key findings

- The patient showed marked clinical improvement after receiving IVIG and methylprednisolone.
- The treatment combination may be beneficial in resource-limited settings with limited advanced treatment options.
- Some degree of cardiac dysfunction persisted despite treatment.

## Abstract

Myocarditis is an acute inflammation of the cardiac muscle cells, resulting in variable degrees of myocardial dysfunction, typically as a result of a viral infection. Clinical symptoms can vary widely depending on the severity of the disease. Even though there are several therapeutic approaches for pediatric myocarditis, the treatment is usually dominated by corticosteroids. Some form of immunomodulatory treatment, most notably intravenous immunoglobulin (IVIG), has been implemented in practice but their effectiveness is controversial and needs more research.

We document the case of a 12-month-old female infant who presented with a three-day history of fever, tachypnea, lethargy, and poor feeding. A workup including laboratory tests, chest X-ray, electrocardiogram, and echocardiogram revealed cardiac dysfunction supporting the diagnosis of acute myocarditis. She received IVIG and methylprednisolone, which resulted in marked clinical improvement, although some degree of cardiac dysfunction persisted. At the time of reporting, she remained under ongoing follow-up care. This case underlines the possible impact of prescribing IVIG with methylprednisolone on children with acute pediatric myocarditis, particularly in resource-limited settings where access to advanced treatment options may be restricted.