Case report
Diphtheritic myocarditis: A histochemical and electron microscopic study

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Abstract

Electron microscopic, histochemical and histologic studies of diphtheritic myocarditis in a 3 year old child who died of cardiac failure are presented. A correlation between biochemical lesions and morphologic alterations of the myocardium is described. The most striking cytopathologic change was mitochondrial damage associated with depletion of glycogen and accumulation of lipid droplets in the damaged myofibers. The changes appeared to progress throughout the myocardial cells.

The localization of the diphtheria toxin was demonstrated in situ in the myocardium by immunofluorescent antibodies. The toxin was patchy in distribution and of varying concentration throughout the myocardium. The toxin was found most frequently and in greatest concentration in the large mononuclear cells which had an eosinophilic cytoplasm in hematoxylineosin stained sections.

Since the pathologic lesions of the myocardium in diphtheria vary and are inconsistent, histochemical and immunofluorescent antibody technics are valuable means for detailed study of the pathology of diphtheritic myocarditis and are of considerable aid in the diagnosis of undetermined cases.

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Cited by (20)

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This study was supported by grants from the U. S. Public Health Service, the Rudolph Matas Memorial Fund for the Kate Prewitt Hess Laboratory and the Rowell A. Billups Fund for Research in Heart Disease.

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