Immunadsorption therapy for end stage heart failure due to Duchenne muscular dystrophy

Reiner Buchhorn, Christian Willaschek, Jochen Selbach, Roland Jahns

Department of Internal Medicine I, Cardiology, Universitaet Wuerzburg, Wuerzburg, Germany.
Department of Internal Medicine III, Nephrology, Caritas Krankenhaus, Bad Mergentheim, Germany.
Department of Pediatrics, Caritas Krankenhaus, Bad Mergentheim, Germany.

DOI: 10.4236/ojped.2013.31003                

Abstract

We report about a successful immunadsorption therapy of a boy with end stage heart failure due to Duchenne muscular dystrophy who has little chance to get cardiac transplantation. Prior to this therapy a medical therapy with an angiotensin converting enzyme inhibitor, a low dose betablocker, an aldosterone antagonist, and diuretics failed. In consent with the patient and his parents immunoadsorption therapy employing a protein A column was performed. Due to clinical improvement the betablocker carvedilol could be titrated from 6.25 mg up to 30 mg. In the following 4 month he improves from NYHA class IV to NYHA class II and NT-Pro-BNP levels fell from 5180 pg/ml to 402 pg/ml. The mean heart rate in Holter ECG decreases from 102/min to 68/min and ejection fraction improved from 25% to 30%. The boy began to walk without any support and was able to visit school. This clinical improvement now holds on for 2 years.

Keywords

Duchenne Muscular Dystrophy, Immunoadsorption Therapy, Heart Failure, Betablocker, Cardiomyopathy

Conflicts of Interest

The authors declare no conflicts of interest.

References

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