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Massive necrotizing myocarditis in a young patient with idiopathic hypereosinophilic syndrome

Ceriello, Laura (author)
University G.d'Annunzio of Chieti-Pescara
Scarinci, Antonino (author)
Mantini, Cesare (author)
University G.d'Annunzio of Chieti-Pescara
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Gallina, Sabina (author)
University G.d'Annunzio of Chieti-Pescara
Cademartiri, Filippo (author)
De Gaspari, Monica (author)
University of Padova
Rizzo, Stefania (author)
University of Padova
Ricci, Fabrizio (author)
Lund University,Lunds universitet,Kardiovaskulär forskning - hypertoni,Forskargrupper vid Lunds universitet,Cardiovascular Research - Hypertension,Lund University Research Groups,Casa di Cura Villa Serena,University G.d'Annunzio of Chieti-Pescara
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University Gd'Annunzio of Chieti-Pescara University of Padova (creator_code:org_t)
Akademiai Kiado Zrt. 2022
2022
English 4 s.
In: IMAGING. - : Akademiai Kiado Zrt.. - 2732-0960. ; 14:1, s. 66-69
  • Journal article (peer-reviewed)
Abstract Subject headings
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  • 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.

Subject headings

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Kardiologi (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)

Keyword

cardiovascular magnetic resonance
echocardiography
endomyocardial biopsy
eosinophilic myocarditis
hypereosinophilic syndrome

Publication and Content Type

art (subject category)
ref (subject category)

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