Fatal Immune Checkpoint Inhibitor-associated Myocarditis Mimicking Infiltrative Cardiomyopathy in a 54-year-old Woman with Metastatic Melanoma
Published on: 4th June, 2024
Introduction: Immune checkpoint inhibitors (ICI) have significantly improved cancer treatment outcomes, but cardiovascular complications such as ICI-associated myocarditis are a major concern. Diagnosing myocarditis requires integrating biomarkers, electrocardiogram (EKG), cardiac imaging, and endomyocardial biopsy. We present a case illustrating these diagnostic challenges, involving a female patient treated with pembrolizumab who developed fatal acute myocarditis mimicking infiltrative cardiomyopathy.Case report: A 54-year-old woman with mucosal melanoma, treated with pembrolizumab, was hospitalized in May 2023 due to dyspnea and elevated troponin levels. Initial cardiac workups were normal, but subsequent tests revealed borderline cardiac magnetic resonance imaging findings. In late May 2023, the patient was admitted with worsening dyspnea, elevated NT-pro-BNP, and severe hyperlactatemia. Imaging and endomyocardial biopsy confirmed acute myocarditis with atypical presentation, mimicking infiltrative cardiomyopathy. Despite aggressive immunosuppressive therapy, the patient’s condition deteriorated, resulting in cardiogenic shock and death seven days post-admission.Conclusion: This case underscores the diagnostic and management challenges of ICI-associated myocarditis, particularly with atypical presentations. It highlights the need for vigilant, comprehensive monitoring and further research to improve diagnostic and therapeutic strategies for managing these severe side effects in patients undergoing ICI therapy.
Clinical Case of Successful Therapy for the Patient with Autism by use of Fetal Stem Cells
Published on: 19th August, 2024
More than 60 million persons all over the world are living with the diagnosis of “Autism”, in accordance with the UNO. According to the WHO, almost every hundredth child is a sufferer of ASD. Such figures emphasize globalization of the problem, and its impact not only on the child’s family but also on the economies of entire countries.Autism diagnosis is difficult and based on the general symptoms in kids. Today, the neuroimaging techniques (methods of functional Magnetic Resonance Imaging (MRI) and MRI tractography), Electroencephalography (EEG), evoked cognitive potentials and dynamic monitoring of the results help with an objective evaluation of stem cell therapy.Treatment options in modern pharmacology and rehabilitation psychotherapy for ASD kids are limited. Therapy methods do not ensure a full integration into social life and personality awareness. To alleviate likely problems in society, different therapeutic approaches exist that might reduce the manifestation of the various autism symptoms. FSC therapy is one such innovative method that has recently become enough popular.We inform about the clinical case of successful treatment using fetal stem cells for a child with autism followed by the period of 1-year follow-up showing significant clinical results. Over one year, the positive changes that had been proved by the ATEC questionnaire, the EEG results, and MRI-tractography were noted by the patient’s family. As emphasized in the clinical case report, fetal stem cell therapy is a promising and efficient treatment for children with autism. All that was sufficiently confirmed by the results acquired because we saw an overall improvement in this patient.
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