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Abstract
Giant cell myocarditis is a rare disorder characterized by the histologic hallmark
of diffuse inflammatory infiltrates with the appearance of multinucleated giant cells.
We report on a 52-year-old man who died of rapidly progressive cardiogenic shock due
to giant cell myocarditis. Serological and immunoblotting techniques revealed a myocardial
infection with coxsackie B2 virus, suggesting a viral etiology of this disease. Here
we present evidence for the involvement of autoimmune responses to the myocardium
as numerous cardiomyocytes exhibited deposits of cell-adherent immunoglobulins. Although
other causative factors may initiate giant cell myocarditis as well, our case suggests
coxsackie B2 virus as one etiologic agent capable of triggering autoimmune reactions
to altered heart tissue.