14) 自己免疫性心筋炎

Autoimmune myocarditis

心筋炎は心筋を主座とした炎症性疾患であり，心膜まで炎症が及ぶと心膜心筋炎と呼ばれる．心筋炎はその臨床病型から，急性，慢性心筋炎に大別される．またその病因から，感染性，非感染性，特発性心筋炎に大別される．また，組織学的特徴から，リンパ球性，巨細胞性，好酸球性，肉芽腫性心筋炎に分類される．本稿では，自己免疫性心筋炎について理解を得られやすいように，はじめに心筋炎について臨床病型ごとにその特徴を示し，さらに自己免疫性心筋炎としての膠原病性心筋炎，および特殊な自己免疫性心筋炎について説明する．

Myocarditis is the inflammatory disease centering on the myocardium and sometimes accompanied with pericarditis.　It is classified into acute and chronic myocarditis according to the clinical phases.　Also, it is classified as infectious, non-infectious, and idiopathic myocarditis according to the etiological peculiarities.　Furthermore, it is also classified as lymphocytic, cytomegalic, eosinophilic, and granulomatous myocatditis according to the histological types.　In this section, we explain firstly these clinical characteristics in every classification, and then systematically add further explanation for autoimmune myocarditis with collagenic and specific diseases.