{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T11:49:56Z","timestamp":1753876196961,"version":"3.41.2"},"reference-count":16,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2024,6,11]],"date-time":"2024-06-11T00:00:00Z","timestamp":1718064000000},"content-version":"vor","delay-in-days":10,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,6,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Acute myocarditis (AM) is an inflammatory heart disease that may occur as a consequence of autoimmune disorders. Although the correlation between myocarditis and hyperthyroidism has been reported in the literature, the association with hypothyroidism is less frequent.<\/jats:p><\/jats:sec><jats:sec><jats:title>Case summary<\/jats:title><jats:p>We describe a characteristic case of lymphocytic acute myocarditis deteriorated into cardiogenic shock due to Hashimoto\u2019s thyroiditis treated with vasopressor and inotropic drugs in combination with corticosteroid. On admission, electrocardiography revealed a sinus tachycardia with 1st degree atrioventricular (AV) block, right bundle branch block (RBBB), and left anterior fascicular block. Laboratory tests demonstrated a severe hypothyroidism and high-titre serum of antibodies against thyroglobulin. She presented a favourable clinical course, restoring haemodynamic stability. A resolution of hypothyroidism and a progressive reduction of the value of antibodies against thyroglobulin occurred. On Day 35, the patient was discharged showing on electrocardiogram the occurrence of left posterior fascicular block, disappearance of 1st degree AV block and partial improvement of RBBB along with the normalization of the left ventricular contractility abnormalities on echocardiography.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>Autoimmune features, mostly Hashimoto\u2019s thyroiditis, are associated in lymphocytic acute myocarditis to a worse prognosis and an increased risk of recurrence. More studies are needed to elucidate the underlying mechanism.<\/jats:p><\/jats:sec>","DOI":"10.1093\/ehjcr\/ytae268","type":"journal-article","created":{"date-parts":[[2024,6,11]],"date-time":"2024-06-11T19:52:49Z","timestamp":1718135569000},"source":"Crossref","is-referenced-by-count":0,"title":["Acute lymphocytic myocarditis characterized by cardiogenic shock and conduction system abnormalities in patients with Hashimoto\u2019s thyroiditis: a case report and review of literature"],"prefix":"10.1093","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-1837-8565","authenticated-orcid":false,"given":"Germana","family":"Panattoni","sequence":"first","affiliation":[{"name":"Division of Cardiology, Policlinico Casilino , Via Casilina 1049, 00169 Rome , Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marco","family":"Marino","sequence":"additional","affiliation":[{"name":"Division of Cardiology, \u2018Tor Vergata\u2019 University Hospital , Rome , Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrea","family":"Ascione","sequence":"additional","affiliation":[{"name":"Department of Experimental Medicine, Sapienza University of Rome , Rome , Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6959-691X","authenticated-orcid":false,"given":"Giulia","family":"d\u2019Amati","sequence":"additional","affiliation":[{"name":"Department of Radiological, Oncological and Pathological Sciences, Sapienza University of Rome , Rome , Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6062-5286","authenticated-orcid":false,"given":"Leonardo","family":"Cal\u00f2","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Policlinico Casilino , Via Casilina 1049, 00169 Rome , Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2024,6,11]]},"reference":[{"key":"2024062814433765800_ytae268-B1","doi-asserted-by":"crossref","first-page":"2636","DOI":"10.1093\/eurheartj\/eht210","article-title":"Current state of knowledge on aetiology, diagnosis, management, and therapy of myocarditis: a position statement of the European Society of Cardiology Working Group on Myocardial and Pericardial Diseases","volume":"34","author":"Caforio","year":"2013","journal-title":"Eur Heart J"},{"key":"2024062814433765800_ytae268-B2","doi-asserted-by":"crossref","first-page":"e007405","DOI":"10.1161\/CIRCHEARTFAILURE.120.007405","article-title":"Management of acute myocarditis and chronic inflammatory cardiomyopathy: an expert consensus document","volume":"13","author":"Ammirati","year":"2020","journal-title":"Circ Heart Fail"},{"key":"2024062814433765800_ytae268-B3","doi-asserted-by":"crossref","first-page":"1098","DOI":"10.1001\/jama.2023.3371","article-title":"Diagnosis and treatment of acute myocarditis: a review","volume":"329","author":"Ammirati","year":"2023","journal-title":"JAMA"},{"key":"2024062814433765800_ytae268-B4","doi-asserted-by":"crossref","first-page":"678645","DOI":"10.3389\/fcvm.2021.678645","article-title":"Focus on autoimmune myocarditis in Graves\u2019 disease: a case-based review","volume":"8","author":"Wu","year":"2021","journal-title":"Front Cardiovasc Med"},{"key":"2024062814433765800_ytae268-B5","doi-asserted-by":"crossref","first-page":"793","DOI":"10.1016\/j.hrthm.2018.11.024","article-title":"Arrhythmias in myocarditis: state of the art","volume":"16","author":"Peretto","year":"2019","journal-title":"Heart Rhythm"},{"key":"2024062814433765800_ytae268-B6","doi-asserted-by":"crossref","first-page":"4519","DOI":"10.1093\/eurheartj\/ehac507","article-title":"Inflammatory infiltration of the cardiac conduction system in acute lymphocytic myocarditis","volume":"43","author":"Caro-Cod\u00f3n","year":"2022","journal-title":"Eur Heart J"},{"key":"2024062814433765800_ytae268-B7","doi-asserted-by":"crossref","first-page":"1995","DOI":"10.1093\/eurheartj\/ehp249","article-title":"Randomized study on the efficacy of immunosuppressive therapy in patients with virus-negative inflammatory cardiomyopathy: the TIMIC study","volume":"30","author":"Frustaci","year":"2009","journal-title":"Eur Heart J"},{"key":"2024062814433765800_ytae268-B8","doi-asserted-by":"crossref","first-page":"3463","DOI":"10.1093\/eurheartj\/ehac348","article-title":"Immunosuppressive therapy in virus-negative inflammatory cardiomyopathy: 20-year follow-up of the TIMIC trial","volume":"43","author":"Chimenti","year":"2022","journal-title":"Eur Heart J"},{"key":"2024062814433765800_ytae268-B9","doi-asserted-by":"crossref","first-page":"1475","DOI":"10.1016\/j.jacc.2009.02.007","article-title":"Cardiovascular magnetic resonance in myocarditis: a JACC white paper","volume":"53","author":"Friedrich","year":"2009","journal-title":"J Am Coll Cardiol"},{"key":"2024062814433765800_ytae268-B10","doi-asserted-by":"crossref","first-page":"55","DOI":"10.20452\/pamw.1499","article-title":"Autoimmune thyroid diseases and nonorgan-specific autoimmunity","volume":"122","author":"Laz\u00farov\u00e1","year":"2012","journal-title":"Pol Arch Med Wewn"},{"key":"2024062814433765800_ytae268-B11","doi-asserted-by":"crossref","first-page":"361","DOI":"10.1007\/s00414-003-0392-5","article-title":"Myocarditis associated with Hashimoto\u2019s disease: a case report","volume":"117","author":"Lorin De La Grandmaison","year":"2003","journal-title":"Int J Legal Med"},{"key":"2024062814433765800_ytae268-B12","doi-asserted-by":"crossref","first-page":"166","DOI":"10.1016\/j.ijcard.2012.04.089","article-title":"Hyperthyroidism induced autoimmune myocarditis. Evaluation by cardiovascular magnetic resonance and endomyocardial biopsy","volume":"158","author":"Mavrogeni","year":"2012","journal-title":"Int J Cardiol"},{"key":"2024062814433765800_ytae268-B13","doi-asserted-by":"crossref","first-page":"601","DOI":"10.1089\/thy.2000.10.601","article-title":"Graves\u2019 disease and low-output cardiac dysfunction: implications for autoimmune disease in endomyocardial biopsy tissue from eleven patients","volume":"10","author":"Fatourechi","year":"2000","journal-title":"Thyroid"},{"key":"2024062814433765800_ytae268-B14","doi-asserted-by":"crossref","first-page":"593","DOI":"10.2169\/internalmedicine.49.2504","article-title":"Thyroid storm and lymphocytic myocarditis","volume":"49","author":"Chen","year":"2010","journal-title":"Intern Med"},{"key":"2024062814433765800_ytae268-B15","doi-asserted-by":"crossref","first-page":"206","DOI":"10.1016\/j.revmed.2019.12.017","article-title":"Acute autoimmune myocarditis secondary to Graves\u2019 disease: a case report","volume":"41","author":"Demoulin","year":"2020","journal-title":"Rev Med Interne"},{"key":"2024062814433765800_ytae268-B16","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1046\/j.1365-2796.1999.00423.x","article-title":"Postpartum onset of acute heart failure possibly due to postpartum autoimmune myocarditis. A report of three cases","volume":"245","author":"Yagoro","year":"1999","journal-title":"J Intern Med"}],"container-title":["European Heart Journal - Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ehjcr\/advance-article-pdf\/doi\/10.1093\/ehjcr\/ytae268\/58192160\/ytae268.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ehjcr\/article-pdf\/8\/6\/ytae268\/58270192\/ytae268.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ehjcr\/article-pdf\/8\/6\/ytae268\/58270192\/ytae268.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,11,21]],"date-time":"2024-11-21T06:13:25Z","timestamp":1732169605000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ehjcr\/article\/doi\/10.1093\/ehjcr\/ytae268\/7690828"}},"subtitle":[],"editor":[{"given":"Costantino","family":"Mancusi","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]},{"given":"Shudhanshu","family":"Alishetti","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]},{"given":"Nikesh","family":"Jathanna","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2024,6,1]]},"references-count":16,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2024,6,1]]}},"URL":"https:\/\/doi.org\/10.1093\/ehjcr\/ytae268","relation":{},"ISSN":["2514-2119"],"issn-type":[{"type":"electronic","value":"2514-2119"}],"subject":[],"published-other":{"date-parts":[[2024,6]]},"published":{"date-parts":[[2024,6,1]]},"article-number":"ytae268"}}