EOSINOPHILIC MYOCARDITIS ASSOCIATED WITH HYPEREOSINOPHILIC SYNDROME

We present the case of a 48-year-old female with acute onset altered mental status, who was found to have eosinophilia, elevated troponin, and embolic strokes. Extensive testing for autoimmune, infectious, and coronary artery etiologies was unremarkable. After a cardiac MRI revealed focal myocardial hyperenhancement, the patient underwent an endomyocardial biopsy with findings consistent with eosinophilic myocarditis. The patient was diagnosed of idiopathic hypereosinophilic syndrome and started on prednisone and apixaban. Our case highlights the importance of considering hypereosinophilic syndrome when eosinophilia is associated with multisystem impairments, as tissue biopsy is usually required to diagnose this rare condition.

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Massive necrotizing myocarditis in a young patient with idiopathic hypereosinophilic syndrome

Imaging ◽

10.1556/1647.2021.00040 ◽

2021 ◽

Author(s):

Laura Ceriello ◽

Antonino Scarinci ◽

Cesare Mantini ◽

Sabina Gallina ◽

Filippo Cademartiri ◽

...

Keyword(s):

Systolic Function ◽

T2 Mapping ◽

Hypereosinophilic Syndrome ◽

Immunosuppressive Treatment ◽

Left Ventricular Systolic Function ◽

Left Ventricular ◽

Response To Treatment ◽

Idiopathic Hypereosinophilic Syndrome ◽

Ventricular Systolic Function ◽

Eosinophilic Myocarditis

Abstract A 27-years-old female with multiple autoimmune disorders presented to our cardiology unit for acute chest pain and worsening dyspnoea. Admission blood tests revealed increased serum levels of high-sensitive cardiac troponin, eosinophilic count and C-reactive protein. Laboratory findings, low QRS voltages by ECG, mildly reduced left ventricular systolic function in the context of pseudohypertrophy, mild and diffuse late gadolinium enhancement associated with markedly increased native T1 and T2 mapping levels assessed by echocardiography and cardiovascular magnetic resonance imaging, raised the suspicion of massive eosinophilic myocarditis, subsequently confirmed by histological examination of endomyocardial biopsy. Prompt initiation of immunosuppressive treatment allowed swift regression of myocardial inflammation and full recovery of left ventricular systolic function within one month. After ruling-out clonal myeloid disorder, lymphocyte-variant and reactive hypereosinophilia, the young lady was eventually diagnosed with idiopathic hypereosinophilic syndrome. This case report turns the spotlight on the role and importance of advanced multi-modality cardiovascular imaging for raising clinical suspicion of acute eosinophilic myocarditis, guiding diagnostic work-up and monitoring response to treatment.

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Eosinophilic Myocarditis in Hypereosinophilic Syndrome

Galicia Clínica ◽

10.22546/55/1855 ◽

2020 ◽

Vol 81 (1) ◽

pp. 25

Author(s):

Rui Assis ◽

Andreia Brito

Keyword(s):

Hypereosinophilic Syndrome ◽

Eosinophilic Myocarditis

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Lymphocyte-Variant Hypereosinophilic Syndrome With Eosinophilic Myocarditis Treated With Steroids and Pegylated Interferon Alfa-2a

The American Journal of the Medical Sciences ◽

10.1016/j.amjms.2017.03.030 ◽

2018 ◽

Vol 355 (2) ◽

pp. 201-202 ◽

Cited By ~ 1

Author(s):

Christopher C. Cheung ◽

Maggie Constantine ◽

Amir Ahmadi ◽

Carolyn Shiau ◽

Luke Y.C. Chen

Keyword(s):

Hypereosinophilic Syndrome ◽

Pegylated Interferon ◽

Interferon Alfa ◽

Eosinophilic Myocarditis ◽

Pegylated Interferon Alfa

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Churg-Strauss Syndrome Presenting as Acute Necrotizing Eosinophilic Myocarditis: Concise Review of the Literature

Current Hypertension Reviews ◽

10.2174/1573402114666180903164900 ◽

2019 ◽

Vol 15 (1) ◽

pp. 8-12 ◽

Cited By ~ 1

Author(s):

Muhammad Ali Chaudhry ◽

Luanda Grazette ◽

Andrew Yoon ◽

Adrian Correa ◽

Michael W. Fong

Keyword(s):

Hypereosinophilic Syndrome ◽

Parasitic Infection ◽

Diagnosis And Treatment ◽

Illustrative Case ◽

Churg Strauss Syndrome ◽

Acute Necrotizing ◽

Strauss Syndrome ◽

Eosinophilic Myocarditis ◽

Disease Entities ◽

Churg Strauss

Background:Acute eosinophilic myocarditis (EM) is a rare form of heart failure that is characterized by myocardial eosinophilic infiltration usually in association with peripheral eosinophilia. The underlying cause is variable and can include allergic reactions, parasitic infection, idiopathic hypereosinophilic syndrome, malignancy, Loeffler’s syndrome, Churg-Strauss syndrome (CSS), early giant cell myocarditis and malignancy. The course is potentially fatal, and early diagnosis and treatment with steroids is essential.Conclusion:Here, we present an illustrative case of eosinophilic myocarditis secondary to CSS followed by a brief review of epidemiology, pathogenesis, diagnosis and treatment of both disease entities.

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