Discussion

Inflammation is a major contributor to the development of cardiovascular illnesses, and anti-inflammatory medications may improve outcomes of these diseases. Colchicine has long been used as a safe and well-tolerated treatment for conditions including gout and familial Mediterranean fever. However, the widely accessible treatment includes various anti-inflammatory properties that have been shown to be useful in a wide range of cardiovascular disorders. ^{Reference Deftereos, Beerkens and Shah1} Colchicine, which is accepted as the standard treatment for pericarditis in adults, post-pericardiotomy syndrome, post-operative and post-ablation atrial fibrillation, coronary artery disorders, prior to percutaneous coronary procedures, and myocarditis are the less utilised indications. ^{Reference Imazio and Nidorf2}

Colchicine is occasionally used to treat myocarditis; however, results from research on adults and children show that it is also effective in treating the condition. In an animal experiment conducted by Pappritz et al. in 2022, it was observed that initiation of colchicine treatment in the early period of viral infection was associated with a decrease in splenic NLRP3 inflammasome activity, less immune cell infiltration in the myocardium, and consequently higher left ventricular function. ^{Reference Pappritz, Lin and El-Shafeey3} In an oral presentation by Morgernstern et al. at the Nineteenth Cardiovascular Magnetic Resonance Society meeting, in a study involving 48 myocarditis patients with pre- and post-treatment MRI data, 27 patients received colchicine treatment and 17 (63%) had complete recovery of myocarditis findings on MRI, while 8 (38%) of 21 patients who did not receive colchicine treatment had recovery of myocarditis findings on MRI. ^{Reference Morgenstern, Lisko, Boniface, Mikolich and Mikolich4}

After the use of the m-RNA immunisation for COVID-19, reports on the use of colchicine in paediatric myocarditis have become increasingly common in the literature. In a study conducted by Truong et al. in 2022 on myocarditis cases after the administration of Covid-19 m-RNA vaccines, colchicine treatment was given in 11 of 139 patients. Colchicine was used due to pericardial involvement and suspicion of myopericarditis. ^{Reference Truong, Dionne and Muniz5} In another study evaluating myocarditis cases after Covid-19 vaccination, colchicine and ibuprofen were used together in six patients. four patients were evaluated as myocarditis, two patients as myopericarditis and no involvement was detected on cardiac MRI in any patient after 3 months of treatment. ^{Reference Manfredi, Bianco and Bucciarelli6}