, Volume 37, Issue 8, pp 849–853 | Cite as

Eosinophilic myocarditis

  • U. BaandrupEmail author
Main topic


Eosinophilic myocarditis is caused by activation of eosinophilic granulocytes whereby there is a release of eosinophilic granules. Quite a few of the released compounds, especially eosinophilic cationic proteins, have a tissue-damaging effect also in the myocardium. Eosinophilia may be due to hypersensitivity, parasitic infection etc. However, in hypereosinophilic syndromes and Loeffler’s endomyocardial disease, the eosinophilia is“idiopathic.” I believe that a clinical spectrum of the disease exists that is intimately correlated with the number of eosinophils and especially the degree of activation. When more is known about the cardiotropism of eosinophils in the various clinical settings, an important step will have been taken toward both the understanding and the treatment of this disease spectrum.


Eosinophilia Eosinophilic myocarditis Allergic myocarditis Hypereosinophilic syndromes Loeffler’s endomyocardial disease Eosinophilic cationic proteins 

Eosinophile Myokarditis


Die eosinophile Myokarditis ist eine seltene Erkrankung, die durch die Aktvierung eosinophiler Granulozyten verursacht wird, die ihre eosinophilen Granula freisetzen. Einige der freigesetzten Substanzen, besonders die eosinophilen kationischen Proteine, wirken auch am Myokard gewebszerstörend. Die Eosinophilie selbst kann Folge unterschiedlicher Ursachen sein, z. B. einer allergischen Reaktion, einer Infektion durch Parasiten usw. Bei den hypereosinophilen Syndromen und bei der Löffler-Endokarditis ist die Ursache der Eosinophilie noch immer ungeklärt, somit gehört sie zu den idiopathischen Formen. Das klinische Spektrum korreliert eng mit dem Ausmaß der Eosinophilenaktivierung. Wäre mehr über den Kardiotropismus der Eosinophilen bekannt, so wäre sowohl die Pathogenese der eosinophilen Myokarditis besser zu verstehen als auch deren Therapie zielgerichteter möglich.


Eosinophilie Eosinophile Myokarditis Allergische Myokarditis Hypereosinophiles Syndrom Löffler-Endomyokarditis Eosinophile kationische Proteine 


Conflict of interest

The corresponding author states that are no conflicts of interest.


  1. 1. Scholar
  2. 2.
    Aretz HAT, Billingham ME, Edwards WD et al (1987) Myocarditis: a histopathologic definition and classification. Am J Cardiovasc Pathol 1:3–14PubMedGoogle Scholar
  3. 3.
    Mason JW, O’Connell JB, Herskowitz A et al (1995) A clinical trial of immunosuppressive therapy for myocarditis. N Engl J Med 333:269–275PubMedCrossRefGoogle Scholar
  4. 4.
    Gravanis MG, Sternby NH (1991) Incidence of myocarditis. Arch Pathol Lab Med 15:390–392Google Scholar
  5. 5.
    Woodruff JF (1998) Viral myocarditis: a review. J Infect 37:424–479Google Scholar
  6. 6.
    Eckart RE, Scoville SL, Campell CL et al (2004) Sudden death in young adults: a 25-year review of autopsies in military recruits. Ann Intern Med 141:829–834PubMedGoogle Scholar
  7. 7.
    Johnson MR (2004) Eosinophilic myocarditis in the explanted hearts of cardiac transplant recipients: interesting pathologic finding or pathophysiologic entity of clinical significance? Crit Care Med 32(3):888–890PubMedCrossRefGoogle Scholar
  8. 8.
    Takkenberg JJ, Czer LS, Fishbein MC et al (2004) Eosinophilic myocarditis in patients awaiting heart transplantation. Crit Care Med 32:712–721CrossRefGoogle Scholar
  9. 9.
    French AJ, Weller CV (1942) Interstial myocarditis following the clinical and experimental use of sulfamide drugs. Am j Pathol 18:109–121PubMedGoogle Scholar
  10. 10.
    Al Ali AM, Straatman LP, Allard MF et al (2006) Eosinophilic myocarditis: case series and review of literature. Can J Cardiol 22(14):1233–1237CrossRefGoogle Scholar
  11. 11.
    Boccara F, Benhaiem-Sigaux N, Cohen A (2001) Acute myopericarditis after diphtheria, tetanus, and polio vaccination. Chest 120:671–672PubMedCrossRefGoogle Scholar
  12. 12.
    Cassimatis D, Atwood JE, Engler R et al (2004) Smallpox vaccination and myopericarditis: a clinical review. J Am Coll Cardiol 43:1503–1510PubMedCrossRefGoogle Scholar
  13. 13.
    Spear GS (1995) Eosinophilic explants carditis with eosinophilia: hypersensitivity to dobutamine infusion. J Heart Lung Transplant 14:755–760PubMedGoogle Scholar
  14. 14.
    Pereira NL, Soon JP, Daly RC et al (2010) De Novo development of eosinophilic myocarditis with left ventricular assist device support as bridge to transplant. Ann Thorac Surg 90:1345–1347PubMedCrossRefGoogle Scholar
  15. 15.
    Courand PY, Croisille P, Khouatra C et al (2012) Churg-Strauss Syndrome presenting with acute myocarditis and cardiogenic shock. Heart Lung Circ 21:178–181PubMedCrossRefGoogle Scholar
  16. 16.
    Setoguchi M, Okishigi K, Sugiyama K et al (2009) Sudden cardiac death associated with Churg-Strauss Syndrome. Circ J 73:2355–2359PubMedCrossRefGoogle Scholar
  17. 17.
    Ginsberg F, Parrillo JE (2005) Eosinophilic myocarditis. Heart Failure Clin 1(3):419–429CrossRefGoogle Scholar
  18. 18.
    Simon U, Rothenberg ME, Bochner BS et al (2010) Refining the definition of hypereosinophilic syndrome. J Allergy Clin Immunol 126:45–49PubMedCrossRefGoogle Scholar
  19. 19.
    Rezaizadeh H, Sanchez-Ross, M, Kaluski E et al (2010) Acute eosinophilic myocarditis: diagnosis and treatment. Acute Cardiac Care 12:31–36PubMedCrossRefGoogle Scholar
  20. 20.
    Grabellus F, Mall G, Scnabel PA et al (2005) Immunohistochemical differentiation of eosinophili heart diseases using antibodies against eosinophil activation markers. Histpathology 46:89–97CrossRefGoogle Scholar
  21. 21.
    Leona O, Veinot JP, Angelini A et al (2012) 2011 Consensus statement on endomyocardial biopsy from the Association for European Cardiovascular Pathology and the Society for Cardiovascular Pathology. Cardiovasc Pathol 21(4):245–74 (E-pub Dec. 2011)CrossRefGoogle Scholar
  22. 22.
    Stone JR, Basso C, Baandrup UT et al (2012) Recommendations for processing cardiovascular surgical pathology specimens: a consensus statement from the Standards and Definitions Committee of the Society for Cardiovascular Pathologyand the Association for European Cardiovascular Pathology. Cardiovasc Pathol 21(1):2–16PubMedCrossRefGoogle Scholar
  23. 23.
    Looi JL, Ruygrok P, Royle G et al (2010) Acute eosinophilic endomyocarditis: early diagnosis and localisation of the lesion by cardiac magnetic resonance imaging. Int J Cardiovasc Imaging 26(Suppl 1):151–154 (E-pub. Jan 2010)PubMedCrossRefGoogle Scholar
  24. 24.
    Kim EY, Chang SA, Lee YK et al (2011) Early non-invasive diagnosis and treatment of acute eosinophilic myopericarditis by cardiac magnetic resonance. J Korean Med Sci 26(11):1522–1526PubMedCrossRefGoogle Scholar
  25. 25.
    Del Bene MR, Cappelli F, Rega L et al (2012) Characterization of Loeffler eosinophilic myocarditis by means of real time three-dimensional contrast-enhanced echocardiography. Echocardiography 29(3):E62–66 (E-pub Nov 2011)CrossRefGoogle Scholar
  26. 26.
    Cools J, DeAngelo DJ, Gorlieb J et al (2003) A tyrosine kinase created by fusion of the PDGFRA and FIP1L1 genes as a therapeutic target of imatinib in idiopathic hypereosinophilic syndrome. N Engl J Med 348(13):1201–1214PubMedCrossRefGoogle Scholar

Copyright information

© Urban & Vogel 2012

Authors and Affiliations

  1. 1.Center for Clinical ResearchVendsyssel Hospital/Aalborg UniversityHjorringDenmark

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