Eosinophilic Myocarditis: A Challenging Diagnosis

Nassereddine, Zahra; Charif, Fida; Najjar, Claudette; Neghawi, Ziad; Saab, Mohamad M.

doi:10.7759/cureus.24371

Cited by 2 publications

(2 citation statements)

References 9 publications

(11 reference statements)

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“…This case did not have any features of the cardiac involvement of sarcoidosis; however, there was evident EM with extensive myocyte necrosis accompanied by eosinophilic arteritis and periarteritis. Two studies have linked sarcoidosis with EM in the literature, however, the exact mechanism is not well-established [19,20]. It is also known that there is a significant overlap between sarcoidosis and granulomatous vasculitides [21].…”

Section: Discussionmentioning

confidence: 99%

Eosinophilic myocarditis from a forensic histopathological perspective

Gün

Buğra

2023

Journal of Forensic Sciences

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Eosinophilic myocarditis (EM) is a rare and potentially fatal form of myocarditis characterized by infiltration of the myocardium with eosinophil leukocytes, often accompanied by eosinophilia. Although the exact underlying cause remains unknown, it has been shown to be associated with hypersensitivity reactions, immune‐mediated disorders, infections, or cancer. Due to the differences in symptomatology, it is often diagnosed by postmortem histopathological examination. We aimed to retrospectively examine the histopathological findings of rare cases of EM and to detect accompanying cardiac and other organ pathologies. The histopathological findings of the cases that underwent autopsies between 2012 and 2020 and were diagnosed with EM were assessed. Demographic features, symptoms, causes of death, macroscopical findings at autopsy, toxicologic and microbiological analysis results, accompanying cardiac pathologies, and histopathological findings in other organs were evaluated. Myocarditis was detected on histopathologic examination in 558 (1.1%) of 49,612 forensic autopsies. There were 12 (2.3%) EM cases. There were nine males and four females. The mean age was 42.3 (3–83) years. Heart weights ranged from 82 to 564 g. The most common finding on macroscopic examination was the mottled discoloration and scarring in the myocardium. Microscopic examination revealed perivascular and interstitial infiltration of eosinophils in all of the cases accompanied by myocyte necrosis in four of them. EM was reported as the cause of death in four cases. EM remains a challenging heart disease with its obscure etiopathogenesis and varying clinical presentation and a rare entity diagnosed by postmortem histopathological examination in sudden and unexpected deaths.

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Section: Discussionmentioning

confidence: 99%

Eosinophilic myocarditis from a forensic histopathological perspective

Gün

Buğra

2023

Journal of Forensic Sciences

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“…Initial presentations vary between nonspecific symptoms to acute heart failure and cardiogenic shock and can even be fatal. The chronic process might lead to fibrosis and restrictive cardiomyopathy (1), and the course might differ in different patients. Initial diagnosis is based on the clinical, laboratory, and imaging manifestations of myocarditis, including electrocardiographic changes, elevated cardiac biomarkers, and evidence of cardiac functional impairment and inflammation in echocardiography, magnetic resonance imaging (MRI), and endomyocardial biopsy (2).…”

Section: Introductionmentioning

confidence: 99%