Case reports

Heart and Vessels

, Volume 12, Issue 1, pp 43-48

Evolution to dilated cardiomyopathy from acute eosinophilic pancarditis in Churg-Strauss syndrome

  • Fumio TerasakiAffiliated withThird Division, Department of Internal Medicine, Osaka Medical College
  • , Tetsuya HayashiAffiliated withThird Division, Department of Internal Medicine, Osaka Medical College
  • , Yuzo HirotaAffiliated withThird Division, Department of Internal Medicine, Osaka Medical College
  • , Makoto OkabeAffiliated withThird Division, Department of Internal Medicine, Osaka Medical College
  • , Michihiro SuwaAffiliated withThird Division, Department of Internal Medicine, Osaka Medical College
  • , Hirofumi DeguchiAffiliated withThird Division, Department of Internal Medicine, Osaka Medical College
  • , Yasushi KitauraAffiliated withThird Division, Department of Internal Medicine, Osaka Medical College
  • , Keishiro KawamuraAffiliated withThird Division, Department of Internal Medicine, Osaka Medical College

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Summary

We describe the clinical manifestations of a patient with Churg-Strauss syndrome who presented with severe acute cardiac involvement and whose disease evolved to dilated cardiomyopathy (DCM), with special reference to the histopathological findings. Endomyocardial biopsies, conducted sequentially, three times within 10 months, revealed severe eosinophilic endomyocarditis in the acute phase, interstitial fibrosis in the subacute phase, and endocardial thickening with mural thrombi, at 10 months. Although acute inflammation associated with elevation of eosinophil granule proteins subsided with steroid therapy, left ventricular dilatation with reduced contractility progressed. A subgroup of DCM is not considered to be idiopathic but, rather, an aftereffect of hypereosinophilic heart disease.

Key words

Hypereosinophilic heart disease Endomyocardial biopsy Churg-Strauss syndrome Dilated cardiomyopathy