Corticosteroid in anti-inflammatory treatment of pediatric acute myocarditis: a systematic review and meta-analysis
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Abstract
BACKGROUND: To evaluate the efficacy of corticosteroids in anti-inflammatory treatment of pediatric acute myocarditis. METHODS: We searched PubMed, Embase and Cochrane library and included studies before October 2022 for clinical trials, observational studies and retrospective studies which reported on children with acute myocarditis treated with corticosteroid anti-inflammatory therapy. The quality of the clinical trials was assessed by Jadad score as an exclusion criterion. RESULTS: This systematic review included 6 studies involving 604 pediatric patients with acute myocarditis. Corticosteroid therapy was not associated with reduced risk of mortality due to acute myocarditis (P = 0.53; RR = 0.87; 95% CI = 0.58 to 1.33) compared to anti-failure treatment. There was a significant improvement in pediatric patients' left ventricular function measured by left ventricular ejection fraction in the group on corticosteroid anti-inflammatory treatment (P = 0.0009; MD = 11.93%; 95% CI = 4.87% to 18.99%). No conclusion can be drawn due to the high heterogeneity in meta-analyses of risk of getting to a clinical endpoint (death or heart transplantation) and changes in left ventricular end-diastolic diameter (LVEDD). CONCLUSIONS: Corticosteroid anti-inflammatory therapy in pediatric acute myocarditis patients showed no significant improvement in reducing the risk of mortality, but showed significant improvement in LVEF.
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Steroids represent the mainstay of immunosuppressive treatment in certain forms of myocarditis and inflammatory cardiomyopathy.
“given that steroids represent the mainstay of immunosuppressive treatment in certain forms of myocarditis and inflammatory cardiomyopathy [38,39].”
From Cardiac Macrophages Exhibit Dynamic Heterogeneity and Functional Specialization During Experimental Autoimmune Myocarditis. (2026) · cites this paper as [39]
The Discussion (page unavailable) says corticosteroids have been widely used for immunosuppression in myocarditis with an autoimmune nature. It does not call them the mainstay or establish their role in inflammatory cardiomyopathy; the Background (page unavailable) says myocarditis treatment remains controversial and generally focuses on supportive care. (LLM, conf=0.84)
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Stefanska, M., Kot, M., Koterba, D., & Zeyland, J. (2026) · Cells · doi:10.3390/cells15121110
- Authors
- Yao, Q., & Zhan, S.
- Affiliations
- Jiaxing University (CN)
- Corresponding author
- Zhan, Shanshan
- Venue
- Italian Journal of Pediatrics
- Published
- 2023-03-13
- Volume
- 49
- Issue
- 1
- Pages
- 30-30
- ISSN
- 1720-8424 (ISSN-L)
- 1824-7288
- PMC
- PMC10012438
- OpenAlex
- W4324026592
- Cited by
- 14
- References
- 39
- Citations by year
- 2026: 5 · 2025: 3 · 2024: 5 · 2023: 1
- FWCI
- 0.73
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- The Italian Journal of Pediatrics/Italian journal of pediatrics (publishedVersion, cc-by)
- Research Square (acceptedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Viral Infections and Immunology Research
- Health Sciences › Medicine › Surgery › Kawasaki Disease and Coronary Complications
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Streptococcal Infections and Treatments
- Keywords
- corticosteroids, anti-inflammatory therapy, mortality, left ventricular ejection fraction, left ventricular function, heart transplantation, children
- MeSH terms
- Adrenal Cortex Hormones, Anti-Inflammatory Agents, Child, Humans, Myocarditis, Retrospective Studies, Stroke Volume, Ventricular Function, Left
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