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Eosinophilic myocarditis in an adolescent: a case report and review of the literature

Published online by Cambridge University Press:  20 September 2012

Ilhan Aslan*
Affiliation:
Department of Congenital Heart Defects, Heart and Diabetes Centre, North-Rhine Westphalia, Bad Oeynhausen, Germany
Marcus Fischer
Affiliation:
Department of Congenital Heart Defects, Heart and Diabetes Centre, North-Rhine Westphalia, Bad Oeynhausen, Germany
Kai T. Laser
Affiliation:
Department of Congenital Heart Defects, Heart and Diabetes Centre, North-Rhine Westphalia, Bad Oeynhausen, Germany
Nikolaus A. Haas
Affiliation:
Department of Congenital Heart Defects, Heart and Diabetes Centre, North-Rhine Westphalia, Bad Oeynhausen, Germany
*
Correspondence to: Dr I. Aslan, Department for Congenital Heart Defects, Heart and Diabetes Center, North-Rhine Westphalia, Georgstrasse 11, D-32545 Bad Oeynhausen, Germany. Tel: (+49) (0) 5731 97 3611; Fax: (+49) (0) 5731 97 2131; E-mail: [email protected]

Abstract

Eosinophilic myocarditis is a rare disease occurring mainly in adulthood. It is generally known to be caused by autoimmune diseases, parasitic infections, hypersensitivity to drugs or substances, and after vaccinations. We describe the case of a 15-year-old adolescent, who presented initially with flu-like symptoms, as well as syncope. Subsequently, catecholaminergic treatment had to be initialised because of cardiac failure. Peripheral eosinophil count was normal at admission and at the time of endomyocardial biopsy. The biopsy, however, proved the diagnosis of eosinophilic myocarditis, but the causative agent remained unclear despite intensive diagnostic work-up. Cardiac magnetic resonance imaging showed signs of acute myocardial oedema and a delayed enhancement in the basal inferolateral segments consistent with acute myocarditis. Under treatment with corticosteroids, angiotensin-converting enzyme inhibitor, and warfarin, we accomplished a rapid and complete recovery of cardiac function and histology. This unique case of eosinophilic myocarditis is rare in childhood. The differential diagnosis and diagnostic pathway is discussed, and a review of the literature and therapeutic options based on the literature is performed.

Type
Brief Report
Copyright
Copyright © Cambridge University Press 2012 

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References

1. Ginsberg, F, Parrillo, JE. Eosinophilic myocarditis. Heart Fail Clin 2005; 1: 419429.CrossRefGoogle ScholarPubMed
2. Barton, M, Finkelstein, Y, Opavsky, MA, et al. Eosinophilic myocarditis temporally associated with conjugate meningococcal C and hepatitis B vaccines in children. The pediatric infectious disease journal 2008; 27: 831835.Google Scholar
3. Bilinska, ZT, Bilinska, M, Grzybowski, J, et al. Unexpected eosinophilic myocarditis in a young woman with rapidly progressive dilated cardiomyopathy. Int J Cardiol 2002; 86: 295297.Google Scholar
4. Brocklington, IF, Olsen, EGJ. Loeffler's endocarditis and Davies’ endomyocardial fibrosis. Am Heart J 1973; 85: 308322.Google Scholar
5. Enko, K, Tada, T, Ohgo, KO, et al. Fulminant eosinophilic myocarditis associated with visceral larva migrans caused by Toxocara canis infection. Circ J: Off J Jpn Circ Soc 2009; 73: 13441348.Google Scholar
6. Spry, CJ, Take, M, Tai, PC. Eosinophilic disorders affecting the myocardium and endocardium: a review. Heart vessels 1985; Suppl 1: 240242.Google Scholar
7. Galiuto, L, Enriquez-Sarano, M, Reeder, GS, et al. Eosinophilic myocarditis manifesting as myocardial infarction: early diagnosis and successful treatment. Mayo Clin Proc 1997; 72: 603610.Google Scholar
8. Lindblade, CL, Kirkpatrick, EC, Ebenroth, ES. Eosinophilic myocarditis presenting with pediatric myocardial infarction. Pediatr cardiol 2006; 27: 162165.CrossRefGoogle ScholarPubMed
9. Sohn, IS, Park, JC, Chung, JH, et al. A case of acute eosinophilic myopericarditis presenting with cardiogenic shock and normal peripheral eosinophil count. Korean J Intern Med 2006; 21: 136140.Google Scholar
10. Mason, JW, O'Connell, JB, Herskowitz, A, et al. A clinical trial of immunosuppressive therapy for myocarditis. N Engl J Med 1995; 333: 269275.Google Scholar
11. Al Ali, AM, Straatman, LP, Allard, MF, et al. Eosinophilic myocarditis: case series and review of literature. Can J Cardiol 2002; 22: 12331237.CrossRefGoogle Scholar
12. Pieroni, M, Cavallaro, R, Chimenti, C, et al. Clozapine-induced hypersensitivity myocarditis. Chest 2004; 126: 17031705.Google Scholar