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Eosinophilic perimyocarditis associated with eosinophilic granulomatosis with polyangiitis: a case report
BACKGROUND: Eosinophilic myocarditis (EM) is a rare and potentially life-threatening form of myocarditis, frequently (but not always) associated with eosinophilia, and presents with acute chest pain, or signs and symptoms of acute or chronic heart failure. Eosinophilic myocarditis has various aetiol...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Oxford University Press
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8564711/ https://www.ncbi.nlm.nih.gov/pubmed/34738066 http://dx.doi.org/10.1093/ehjcr/ytab399 |
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author | Blumetti, Ludovica De Perna, Maria Luisa Reinehr, Michael Pedrazzini, Giovanni |
author_facet | Blumetti, Ludovica De Perna, Maria Luisa Reinehr, Michael Pedrazzini, Giovanni |
author_sort | Blumetti, Ludovica |
collection | PubMed |
description | BACKGROUND: Eosinophilic myocarditis (EM) is a rare and potentially life-threatening form of myocarditis, frequently (but not always) associated with eosinophilia, and presents with acute chest pain, or signs and symptoms of acute or chronic heart failure. Eosinophilic myocarditis has various aetiologies, including eosinophilic granulomatosis with polyangiitis (EGPA). CASE SUMMARY: A 52-year-old female with a long-standing history of asthma, acral paraesthesia, subcutaneous nodules, and recurrent chest pain treated with anti-inflammatory drugs was admitted to our hospital with chest pain, repolarization disturbances, eosinophilia, and increased troponin levels. After an initial evaluation by coronary angiography, echocardiography and cardiac magnetic resonance, a definitive diagnosis of EM was made with the help of an endomyocardial biopsy. The aetiological diagnosis of EM as a manifestation of tissue involvement in EGPA was concluded after ruling out other possible causes of eosinophilia and with the help of other diagnostic criteria for EGPA (asthma, eosinophilia, and neuropathy). Therefore, we started with a high dosage of glucocorticoids, and attained relief of symptoms and normalization of eosinophilic count after a few days. DISCUSSION: In cases of myocarditis (particularly if associated with eosinophilia), EM is a manifestation of EGPA and should be considered for a prompt differential diagnosis. Endomyocardial biopsy represents the gold standard for the diagnosis of EM. The mainstay of therapy for EM is immunosuppressive drugs to help prevent its evolution to a fulminant form and chronic progression towards restrictive cardiomyopathy. |
format | Online Article Text |
id | pubmed-8564711 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-85647112021-11-03 Eosinophilic perimyocarditis associated with eosinophilic granulomatosis with polyangiitis: a case report Blumetti, Ludovica De Perna, Maria Luisa Reinehr, Michael Pedrazzini, Giovanni Eur Heart J Case Rep Case Report BACKGROUND: Eosinophilic myocarditis (EM) is a rare and potentially life-threatening form of myocarditis, frequently (but not always) associated with eosinophilia, and presents with acute chest pain, or signs and symptoms of acute or chronic heart failure. Eosinophilic myocarditis has various aetiologies, including eosinophilic granulomatosis with polyangiitis (EGPA). CASE SUMMARY: A 52-year-old female with a long-standing history of asthma, acral paraesthesia, subcutaneous nodules, and recurrent chest pain treated with anti-inflammatory drugs was admitted to our hospital with chest pain, repolarization disturbances, eosinophilia, and increased troponin levels. After an initial evaluation by coronary angiography, echocardiography and cardiac magnetic resonance, a definitive diagnosis of EM was made with the help of an endomyocardial biopsy. The aetiological diagnosis of EM as a manifestation of tissue involvement in EGPA was concluded after ruling out other possible causes of eosinophilia and with the help of other diagnostic criteria for EGPA (asthma, eosinophilia, and neuropathy). Therefore, we started with a high dosage of glucocorticoids, and attained relief of symptoms and normalization of eosinophilic count after a few days. DISCUSSION: In cases of myocarditis (particularly if associated with eosinophilia), EM is a manifestation of EGPA and should be considered for a prompt differential diagnosis. Endomyocardial biopsy represents the gold standard for the diagnosis of EM. The mainstay of therapy for EM is immunosuppressive drugs to help prevent its evolution to a fulminant form and chronic progression towards restrictive cardiomyopathy. Oxford University Press 2021-10-07 /pmc/articles/PMC8564711/ /pubmed/34738066 http://dx.doi.org/10.1093/ehjcr/ytab399 Text en © The Author(s) 2021. Published by Oxford University Press on behalf of the European Society of Cardiology. https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com |
spellingShingle | Case Report Blumetti, Ludovica De Perna, Maria Luisa Reinehr, Michael Pedrazzini, Giovanni Eosinophilic perimyocarditis associated with eosinophilic granulomatosis with polyangiitis: a case report |
title | Eosinophilic perimyocarditis associated with eosinophilic granulomatosis with polyangiitis: a case report |
title_full | Eosinophilic perimyocarditis associated with eosinophilic granulomatosis with polyangiitis: a case report |
title_fullStr | Eosinophilic perimyocarditis associated with eosinophilic granulomatosis with polyangiitis: a case report |
title_full_unstemmed | Eosinophilic perimyocarditis associated with eosinophilic granulomatosis with polyangiitis: a case report |
title_short | Eosinophilic perimyocarditis associated with eosinophilic granulomatosis with polyangiitis: a case report |
title_sort | eosinophilic perimyocarditis associated with eosinophilic granulomatosis with polyangiitis: a case report |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8564711/ https://www.ncbi.nlm.nih.gov/pubmed/34738066 http://dx.doi.org/10.1093/ehjcr/ytab399 |
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