Clinical & Experimental Cardiology
Open Access

Abstract

Myocarditis as an Extraintestinal Manifestation of Inflammatory Bowel Disease

Roney Shibu* and Waled Mohsen

Inflammatory Bowel Disease (IBD) is a chronic autoimmune disorder categorised into Crohn’s disease and IBD associated myocarditis. Extraintestinal Manifestations (EIMs) of IBD include rare and potentially fatal presentations like acute myocarditis, which may be complicated by acute inflammatory heart failure, cardiogenic shock and ventricular arrythmias. We reviewed the existing literature on myocarditis occurring as an EIM of IBD to identify populations at higher risk, evaluate cardiac outcomes and explore management. A literature review showed 27 cases of IBD related myocarditis and there were similar number of patients with Crohn’s Disease (CD) and Ulcerative Colitis (UC). IBD patients under 30 years of age, including paediatric patients, were more commonly affected. Diagnosis of IBD associated myocarditis occurred within 2 years of IBD diagnosis in 63% of patients, mostly during periods of intestinal disease activity. 37% manifested at the time of IBD diagnosis. Infliximab, a TNF-α inhibitor, may be an effective and safe therapeutic option for steroid refractory myocarditis in this high-risk patient group, who have worse cardiac outcomes compared to the general myocarditis population. Understanding of IL-1 mediated inflammation in the pathogenesis of IBD, EIMs and myocarditis is evolving. Although this may be an attractive therapeutic target, further research on its efficacy and safety in IBD and high-risk myocarditis is required.

Published Date: 2024-09-05; Received Date: 2024-08-06