Eosinophilic Myocarditis due to Churg-Strauss Syndrome With Markedly Elevated Eosinophil Cationic Protein

Hara, Tomoya; Yamaguchi, Koji; Igarashi, Takashi; Kadota, Muneyuki; Bando, Mika; Ogasawara, Kozue; Bando, Shigenobu; Ise, Takayuki; Niki, Toshiyuki; Ueda, Yuka; Tomita, Noriko; Taketani, Yuji; Yamada, Hirotsugu; Soeki, Takeshi; Wakatsuki, Tetsuzo; Sata, Masataka

doi:10.1536/ihj.54.51

Cited by 27 publications

(17 citation statements)

References 8 publications

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“…Amniotic fluid embolism 9) and eosinophilic myocarditis 10) were previously reported as rare but important causes. PTTM can also induce rapid progressive dyspnea.…”

Section: Discussionmentioning

confidence: 99%

Platelet-Derived Growth Factor Receptor-Tyrosine Kinase Inhibitor, Imatinib, Is Effective for Treating Pulmonary Hypertension Induced by Pulmonary Tumor Thrombotic Microangiopathy

et al. 2015

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SummaryPulmonary hypertension (PH) induced by pulmonary tumor thrombotic microangiopathy (PTTM) can be fatal because its rapid progression confounds diagnosis, and it is difficult to control with therapy. Here we describe a woman with symptomatic PTTM-PH accompanying gastric cancer that was suspected from perfusion scintigraphy. PTTM-PH was diagnosed by gastroesophageal endoscopy and lung biopsy after partial control of PH using the platelet-derived growth factor (PDGF) receptor (PDGFR) tyrosine kinase inhibitor, imatinib. Treatment with sildenafil and ambrisentan further decreased PH, and she underwent total gastrectomy followed by adjuvant TS-1 chemotherapy. PH did not recur before her death from metastasis. Postmortem histopathology showed recanalized pulmonary arteries where the embolized cancer masses disappeared. PDGF-A, -B, and PDGFR-α, β expression was detected in cancer cells and proliferating pulmonary vascular endothelial cells. Thus, PTTM-PH was successfully controlled using a combination of imatinib, drugs to treat pulmonary arterial hypertension, and cancer management. (Int Heart J 2015; 56: 245-248)

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“…Amniotic fluid embolism 9) and eosinophilic myocarditis 10) were previously reported as rare but important causes. PTTM can also induce rapid progressive dyspnea.…”

Section: Discussionmentioning

confidence: 99%

Platelet-Derived Growth Factor Receptor-Tyrosine Kinase Inhibitor, Imatinib, Is Effective for Treating Pulmonary Hypertension Induced by Pulmonary Tumor Thrombotic Microangiopathy

et al. 2015

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“…Usually, Creactive protein (CRP) and erythrocyte sedimentation rate are increased only in the acute phase. Furthermore, eosinophilic cationic protein (ECP) may be elevated in EGPA, and, if so, ECP is useful for monitoring of disease activity 5,6 .…”

Section: This Report Resumes Three Cases Of Churg-strauss Syndrome (Cmentioning

confidence: 99%

Churg-Strauss syndrome with cardiac involvement: case illustration and contribution of CMR in the diagnosis and clinical follow-up

d'Ersu

Ribi

Monney

et al. 2018

International Journal of Cardiology

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This report summarises three cases of Churg-Strauss syndrome (CSS) illustrating the diagnostic challenges associated with the cardiac manifestation of this disease. Here, we illustrate the role of cardiac magnetic resonance (CMR) for diagnosis and follow-up of CSS with a focus on new non-contrast T-weighted imaging sequences for quantification of myocardial scar tissue and quantitative T mapping techniques, which allow the detection of myocardial edema.

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“…Furthermore, we should also rule out systemic autoimmune disease such as systemic lupus erythematosus and ANCA-associated vasculitis diseases. 9) However, systemic autoimmune diseases were ruled out in this case. After her polyarthritis developed, we measured her ASO level.…”

Section: Discussionmentioning

confidence: 84%

A Case of Adult-Onset Acute Rheumatic Fever With Long-Lasting Atrioventricular Block Requiring Permanent Pacemaker Implantation

et al. 2015

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SummaryA 45-year-old hypertensive Japanese woman presented with epigastric pain on inspiration, fever, complete atrioventricular block and polyarthritis. Her antistreptolysin O levels were markedly elevated. A diagnosis of rheumatic fever was made according to the modified Jones criteria. She was prescribed loxoprofen sodium, which was partially effective for her extracardiac clinical symptoms. However, she had syncope due to complete atrioventricular block with asystole longer than 10 seconds. Consequently, we implanted a permanent pacemaker. Although we prescribed prednisolone, the efficacy of which was limited for the patient's conduction disturbance, the complete atrioventricular block persisted. In our systematic review of 12 similar cases, the duration of complete heart block was always transient and there was no case requiring a permanent pacemaker. We thus encountered a very rare case of adult-onset acute rheumatic fever with persistent complete atrioventricular block necessitating permanent pacemaker implantation. (Int Heart J 2015; 56: 664-667) Key words: Carditis, ASO, Complete atrioventricular block A cute rheumatic fever is an autoimmune disorder following post-suppurative streptococcal pharyngitis, which leads variably to arthritis, chorea, dermal manifestations, and most importantly, carditis. Acute rheumatic fever usually occurs in children between the ages of 5 and 15 years. In Japan and other developed countries, the incidence of acute rheumatic fever has fallen to very low levels due to improved hygienic standards and the routine use of antibiotics for acute pharyngitis. In fact, in Japan, according to a patient survey by the Ministry of Health, Labour and Welfare, it has been too rare a disease to count the total number of patients since 2005.Cases of adult-onset acute rheumatic fever with complete atrioventricular block have been reported in developed countries, though very rarely. It has been reported that patients with adult-onset acute rheumatic fever sometimes develop complete atrioventricular block due to excessive vagal tonus activation. 1)Therefore, most researchers have reported that the dysfunction of the atrioventricular node caused by adult-onset acute rheumatic fever might be transient or reversible.2-7) Against this background, we experienced a very rare case of a patient diagnosed with adult-onset acute rheumatic fever with complete atrioventricular block requiring implantation of a permanent pacemaker. We report the details of this case and discuss the relevant earlier case reports. Case ReportFive days before admission, a 45-year-old Japanese woman who had been receiving antihypertensive therapy (doxazosin 1 mg/day) for 3 years presented with epigastric pain on inspiration. She was admitted to another hospital due to fever with temperatures above 38°C and complete atrioventricular block (65 beats/minute). Neither she nor her family members had any history of upper respiratory tract infection. There was no other history of cardiorespiratory complaints. There was no familial...

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Eosinophilic Myocarditis due to Churg-Strauss Syndrome With Markedly Elevated Eosinophil Cationic Protein

Cited by 27 publications

References 8 publications

Platelet-Derived Growth Factor Receptor-Tyrosine Kinase Inhibitor, Imatinib, Is Effective for Treating Pulmonary Hypertension Induced by Pulmonary Tumor Thrombotic Microangiopathy

Platelet-Derived Growth Factor Receptor-Tyrosine Kinase Inhibitor, Imatinib, Is Effective for Treating Pulmonary Hypertension Induced by Pulmonary Tumor Thrombotic Microangiopathy

Churg-Strauss syndrome with cardiac involvement: case illustration and contribution of CMR in the diagnosis and clinical follow-up

A Case of Adult-Onset Acute Rheumatic Fever With Long-Lasting Atrioventricular Block Requiring Permanent Pacemaker Implantation

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