Eosinophilic myocarditis in a patient with hypertrophic cardiomyopathy

• Type: Summary of Presentation in an International Conference
• Date: 2012

Authors

Rangel I (Author) Other; Martins E (Author) Other; Sousa C (Author) Other; Oliveira S (Author) Other; Lebreiro A (Author) Other; Sousa A (Author) Other; Correia AS (Author) Other; Paiva M (Author) Other; Ribeiro V (Author) Other; Melão F (Author) Other; Vasconcelos M (Author) Other; Maciel MJ (Author) FMUP

Conference proceedings International

Title: European Journal of Heart Failure Supplements

Initial page: P1032

Heart Failure Congress 2012

Belgrade, 2012

Scientific classification

FOS: Medical and Health sciences > Clinical medicine

Other information

Abstract (EN): We report the case of a 60-year-old woman with history of hypertension, family history of hypertrophic cardiomyopathy (HCM) and hyperpigmented skin lesions of unknown etiology. She had clinical heart failure (HF) since 8 years ago, with progressive worsening. A transthoracic echocardiogram showed concentric left ventricular hypertrophy with septal predominance. Electrical instability has been documented (atrial fibrillation with rapid ventricular response and runs of nonsustained ventricular tachycardia). Cardiac magnetic resonance imaging revealed asymmetric septal hypertrophy and multiple foci of delayed enhancement suggestive of myocardial fibrosis. The HCM genetic test was negative. For further clarification, endomyocardial biopsy (EMB) was done, which showed histiocytes and eosinophils infiltration, suggestive of eosinophilic myocarditis. There have not been identified drugs capable of inducing a hypersensitivity reaction. In November 2010, the patient was hospitalized for decompensated heart failure. Analytically, it was found the presence of peripheral eosinophilia and, attending the findings of the EMB, complementary investigation was performed, which included: bone marrow examination and biopsy (no evidence of neoplastic process), thoraco-abdominal-pelvic computerized axial tomography (no significant changes) and parasitic infection test (negative). A skin lesion biopsy revealed inflammatory infiltrate, rich in eosinophils and neutrophils. Given the progressive clinical deterioration, the presence of eosinophilic myocarditis and probable multi-organ systemic involvement, steroid therapy was started, leading to rapid resolution of peripheral eosinophilia. This case illustrates the occurrence of eosinophilic myocarditis in a patient with suggestive findings of HCM. Eosinophilic cardiomyopathy may result in rapid clinical deterioration in the absence of specific therapy, emphasizing the role of the EMB for the diagnosis.

Language: English

Type (Professor's evaluation): Scientific

Notes: Rangel I, Martins E, Sousa C, Oliveira S, Lebreiro A, Sousa A, Correia AS, Paiva M, Ribeiro V, Melão F, Vasconcelos M, Maciel MJ. Eosinophilic myocarditis in a patient with hypertrophic cardiomyopathy. Eur J Heart Fail Suppl 2012; 11(Suppl 1): P1032. ISSN 1567-4215.Heart Failure Congress 2012, Belgrade, 2012