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      A case report of eosinophilic myocarditis and a review of the relevant literature

      case-report

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          Abstract

          Background

          Eosinophilic myocarditis (EM) is a relatively rare condition that may result from parasitic infections and allergic disease. Antituberculosis drugs may lead to focal myocardial infiltration by eosinophils (eosinophilic myocarditis). Symptoms may be severe, and, lead to rapidly-fatal outcomes. Early diagnosis and high-dose corticosteroids are the cornerstone of treatment, and, may lead to restoration of cardiac function with full recovery.

          Case presentation

          We report a case of eosinophilic myocarditis secondary to eosinophilia caused by antituberculosis drugs with markedly elevated ECP, focal eosinophilic infiltration in CMR imaging and endomyocardial biopsy. Finally, high-dose corticosteroids were used to reverse the cardiac injury and to improve the clinical outcome.

          Conclusion

          Antituberculosis drugs can cause eosinophilic infiltration of, and damage to, the myocardium leading to rapid progression of the clinical symptoms. Myocardial biopsy is helpful in diagnosing the disease in the early stages and high-dose corticosteroids effectively improves the prognosis of this disease.

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          Most cited references23

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          Guidelines for the diagnosis and treatment of chronic heart failure.

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            The hypereosinophilic syndrome: analysis of fourteen cases with review of the literature.

            Several closely related disease entities make up the idiopathic hypereosinophilic syndrome (HES). The syndrome is manifest by persistent and prolonged eosinophilia with organ damage. A group of 14 patients had hematologic, cardiac, and neurologic abnormalities attributable to this disease. Patient survival and response to chemotherapy was significantly better in this group than in previously reported patients. The etiology of HES remains unknown, as does the mechanism of tissue damage.
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              Cardiovascular manifestations of hypereosinophilic syndromes.

              The hypereosinophilic syndromes (HESs) are characterized by persistent marked eosinophilia (>1500 eosinophils/mm(3)), the absence of a primary cause of eosinophilia (such as parasitic or allergic disease), and evidence of eosinophil-mediated end organ damage. Cardiovascular complications of HES are a major source of morbidity and mortality in these disorders. The most characteristic cardiovascular abnormality in HES is endomyocardial fibrosis. Patients who have an HES also may develop thrombosis, particularly in the cardiac ventricles, but also occasionally in deep veins. Because of the rarity of these disorders, specific guidelines for the management of the cardiac and thrombotic complications of HES are lacking. This article reviews the diagnosis and management of the cardiovascular manifestations of HES.
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                Author and article information

                Contributors
                lihaiying111@gmail.com
                daiyupi@163.com
                wangbinqiao@hotmail.com
                wangbinqiao@hotmail.com
                Journal
                BMC Cardiovasc Disord
                BMC Cardiovasc Disord
                BMC Cardiovascular Disorders
                BioMed Central (London )
                1471-2261
                26 February 2015
                26 February 2015
                2015
                : 15
                : 15
                Affiliations
                Department of Cardiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000 China
                Article
                3
                10.1186/s12872-015-0003-7
                4359588
                25887327
                bbc5be26-8dda-445f-8ebf-be2e10766425
                © Li et al.; licensee BioMed Central. 2015

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 25 November 2014
                : 5 February 2015
                Categories
                Case Report
                Custom metadata
                © The Author(s) 2015

                Cardiovascular Medicine
                eosinophils,antituberculosis drugs,myocarditis,corticosteroids
                Cardiovascular Medicine
                eosinophils, antituberculosis drugs, myocarditis, corticosteroids

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