1/113. Eosinophilic myocarditis associated with dense deposits of eosinophil cationic protein (ECP) in endomyocardium with high serum ECP.A case of eosinophilic myocarditis following high serum levels of eosinophil cationic protein (ECP) is described. A 27 year old woman was admitted with new york Heart association (NYHA) class III congestive heart failure. A haematological study showed hypereosinophilia with degranulation and vacuoles; the total eosinophil count was 7980/ml and the ECP serum concentration was noticeably high at 150 ng/ml. Endomyocardial biopsy from the right ventricle showed infiltration of eosinophils and dense deposits of ECP in the endocardium as well as the myocardium. Steroid treatment returned the total eosinophil count and serum ECP to normal, with satisfactory improvement in clinical features. eosinophilia may cause cardiac damage, and this report confirms that eosinophil degranulation is toxic. Thus, serum ECP seems to be a reliable indicator for diagnosis and for determining treatment parameters of eosinophilic myocarditis.- - - - - - - - - - ranking = 1keywords = heart failure, heart, cardiac (Clic here for more details about this article) |
2/113. Eosinophilic infiltration immediately following transplantation: recurrent hypersensitivity reaction?hypersensitivity myocarditis is a well-known complication of pharmaceutical therapy, often requiring heart transplantation. We report the unusual case of pre-transplant hypersensitivity myocarditis with eosinophilic myocardial infiltration in the donor heart, demonstrated by needle biopsy at the time of transplant ('time-zero' biopsy). At first the myocarditic process was temptatively attributed to a pre-transplant pathology in the donor heart, but the close similarity between the pre-transplant and the post-transplant infiltrate and the clinical data of an eosinophilic peak of the recipient during the transplant procedure brought to the diagnosis of early recurrent hypersensitivity myocarditis.- - - - - - - - - - ranking = 0.78619222003168keywords = heart (Clic here for more details about this article) |
3/113. Complete haematological and cytogenetic response to interferon alpha-2a of a myeloproliferative disorder with eosinophilia associated with a unique t(4;7) aberration.A female patient with eosinophilia and cardiac symptoms was found to have a unique chromosomal aberration [t(4;7)(q11;p13)] of bone-marrow precursors. The disorder was classified as a chronic myeloproliferative syndrome with eosinophilia. Due to a significant increase in the white blood cell and eosinophil count during initial treatment with prednisone and hydroxyurea, Interferon alpha-2a was administered at a dose of 3-5 x 10(6) I.U. s.c., five times per week, and induced a long-term complete haematological and cytogenetic response. The clinical features of this case are presented and discussed in the context of the current literature.- - - - - - - - - - ranking = 0.12844718091201keywords = cardiac (Clic here for more details about this article) |
4/113. churg-strauss syndrome complicated by eosinophilic endomyocarditis.A 34-year-old woman with asthma had increasing dyspnea on exertion for 9 months and new-onset mononeuritis multiplex. An examination demonstrated sinus tachycardia, elevated jugular venous pressure, and a tender nonpulsatile liver. The leukocyte count was 15.8 x 10(9)/L, with 23% eosinophils. echocardiography revealed a laminated thrombus obliterating much of the right ventricular cavity, with encasement of the tricuspid valve. Ultrafast computed tomography showed no evidence of pulmonary emboli. biopsy specimens of skin nodules revealed extravascular palisading granulomas. The thrombus was refractory to corticosteroids, and right ventricular thrombectomy was performed. To our knowledge, this is the third reported case of churg-strauss syndrome with thrombotic complications from coexistent eosinophilic endomyocarditis. In an asthmatic patient with chronic dyspnea, eosinophilic tissue infiltration, and neuropathy, churg-strauss syndrome should be considered; evaluation for cardiac involvement may be warranted.- - - - - - - - - - ranking = 0.12844718091201keywords = cardiac (Clic here for more details about this article) |
5/113. Holt-Oram syndrome revisited. Two patients in the same family.Holt-Oram syndrome was first described in 1960 as an association of familial heart disease and musculoskeletal abnormalities. The most important findings include atrial septal defects, atrioventricular conduction abnormalities, vascular hypoplasia, and upper limb musculoskeletal deformities. We report two patients with this syndrome in the same family and discuss the variability of the musculoskeletal abnormalities and their association with the cardiac morphologic defects. Both patients in this study had associated eosinophilia, which has not been reported in the literature.- - - - - - - - - - ranking = 0.3905112542559keywords = heart, cardiac (Clic here for more details about this article) |
6/113. life-threatening eosinophilic pleuropericardial effusion related to vitamins B5 and H.OBJECTIVE: To report a case of eosinophilic pleuropericarditis resulting from concomitant use of vitamins B5 and H. CASE SUMMARY: A 76-year-old white woman was admitted to the hospital because of chest pain and dyspnea related to pleurisy and a pericardial tamponade. This patient had no history of allergy and had been taking vitamins B5 and H for two months. blood tests performed showed an inflammatory syndrome and a high eosinophil concentration (1200-1500 cells/mm3). Pleurocentesis and pericardiotomy yielded a sterile exudative fluid with an eosinophilic infiltrate. There were no nuclear antibodies and no rheumatic factor; screenings for viruses, parasites, bacteria, and malignant tumor were negative. A myelogram, biopsy of the iliac crest bone, and concentration of immunoglobulin e were also normal. After withdrawal of the vitamins, the patient recovered and the eosinophilia disappeared. DISCUSSION: Prolonged hypereosinophilia has marked predilection to damage specific organs, including the heart, but pleuropericardial effusion is uncommon. Drug-related pleuropericarditis usually occurs without an increased eosinophil count. Other drugs responsible for eosinophilic pleuropericarditis are cephalosporins, dantrolene, propylthiouracil, and nitrofurantoin. To our knowledge, this is the first case report of pleuropericarditis related to vitamins B5 and H. CONCLUSIONS: This case suggests that vitamins B5 and H may cause symptomatic, life-threatening, eosinophilic pleuropericarditis. physicians prescribing these commonly used vitamins should be aware of this potential adverse reaction.- - - - - - - - - - ranking = 0.26206407334389keywords = heart (Clic here for more details about this article) |
7/113. Acute necrotizing eosinophilic myocarditis successfully treated by high dose methylprednisolone.Acute necrotizing eosinophilic myocarditis is the most severe form of eosinophilic myocarditis, or hypersensitivity myocarditis, and is characterized by rapidly progressive congestive heart failure followed by fulminant clinical deterioration that is nearly always fatal. A 55-year-old previously healthy patient with acute necrotizing eosinophilic myocarditis was diagnosed by early myocardial biopsy and successfully treated with corticosteroids. Throughout his hospitalization, the eosinophil count in the peripheral blood remained normal (56-201/mm3). Early stage corticosteroid therapy can have dramatic effects in acute necrotizing eosinophilic myocarditis and early diagnosis by endomyocardial biopsy is recommended.- - - - - - - - - - ranking = 0.87155281908799keywords = heart failure, heart (Clic here for more details about this article) |
8/113. Acute myocarditis with transient eosinophilia and serum hyper-IgE-emia in a patient with atopic dermatitis.A 14-year-old girl with acute myocarditis, transient eosinophilia, and hyper-IgE-emia associated with atopic dermatitis is described. The patient was admitted because of severe heart failure and shock, and severe atopic dermatitis was seen. blood examinations showed moderate eosinophilia (1917/mm3) and hyper-IgE-emia (830IU/ml). The response to treatment with dopamine was excellent, and the congestive heart failure was gradually ameliorated, followed by improvement in her atopic dermatitis. In addition, rapid improvement in eosinophilia and hyper-IgE-emia was observed. Histopathological examination of the right ventricular myocardium obtained by endomyocardial biopsy showed mild interstitial fibrosis and mild infiltrations of inflammatory cells, indicating myocarditis. We speculated that the transient eosinophilia and hyper-IgE-emia in the present case indicated that an allergen induced strong allergic reactions, including type 1 allergy, and caused both acute myocarditis and deterioration of the atopic dermatitis; specifically noteworthy is that the patient's disease rapidly improved without corticosteroid treatment.- - - - - - - - - - ranking = 1.743105638176keywords = heart failure, heart (Clic here for more details about this article) |
9/113. Idiopathic eosinophilic endomyocarditis in the absence of peripheral eosinophilia.In this case report we present two patients with unusual manifestations of eosinophilic endomyocarditis: A 69-year-old patient with a history of heart failure and ventricular fibrillation and a 16-year-old woman with ventricular fibrillation and an ECG indicating acute myocardial infarction had both normal blood eosinophil counts at the onset of symptoms. The absence of hypereosinophilia, therefore, does not exclude the presence of eosinophilic organ infiltration. Endomyocardial biopsy may be the only diagnostic procedure to identify necrotic eosinophilic endomyocarditis in patients with unexplained heart failure or ventricular fibrillation.- - - - - - - - - - ranking = 1.743105638176keywords = heart failure, heart (Clic here for more details about this article) |
10/113. Eosinophilic heart disease with vasculitis: supported by HeartMate left ventricular assist device and heart transplantation.Eosinophilic heart disease is rarely seen in clinical practice. We report a patient with eosinophilic heart disease who presented with acute myocardial infarction and congestive heart failure. Because of lack of a donor organ and progressive deterioration of his general condition in spite of intraaortic balloon pumping, a left ventricular assist device (HeartMate 1000 IP; Thermo Cardiosystems Inc, Woburn, MA) was implanted before development of irreversible multiple organ failure and was followed by heart transplantation.- - - - - - - - - - ranking = 3.7542576258708keywords = heart failure, heart (Clic here for more details about this article) |
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