Fatal myocarditis in a child with systemic onset juvenile idiopathic arthritis during treatment with an interleukin 1 receptor antagonist

Background: the pathologic diagnosis of isolated myocarditis without pericardial involvement is uncommonly encountered in systemic onset juvenile idiopathic arthritis (sojia).case: an eleven year-old boy with sojia died suddenly while being treated with the interleukin 1 (il-1) receptor inhibitor,anakinra. his autopsy revealed an enlarged heart and microscopic findings were consistent with myocarditis,but not pericarditis. viral pcr testing performed on his myocardial tissue was negative.conclusion: this case illustrates myocarditis as a fatal complication of sojia,potentially enabled by anakinra. © 2012 zeft et al; licensee biomed central ltd.