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Case Reports
. 2008 May 8;10(1):21.
doi: 10.1186/1532-429X-10-21.

Time course of eosinophilic myocarditis visualized by CMR

Kurt Debl  1 , Behrus Djavidani, Stefan Buchner, Florian Poschenrieder, Norbert Heinicke, Stefan Feuerbach, Günter Riegger, Andreas Luchner
Affiliations
Case Reports

Time course of eosinophilic myocarditis visualized by CMR

Kurt Debl et al. J Cardiovasc Magn Reson. .

Abstract

We report the diagnostic potential of cardiovascular magnetic resonance (CMR) to visualize the time course of eosinophilic myocarditis upon successful treatment. A 50-year-old man was admitted with a progressive heart failure. Endomyocardial biopsies were taken from the left ventricle because of a white blood cell count of 17000/mm3 with 41% eosinophils. Histological evaluation revealed endomyocardial eosinophilic infiltration and areas of myocyte necrosis. The patient was diagnosed with hypereosinophilic myocarditis due to idiopathic hypereosinophilic syndrome. CMR-studies at presentation and a follow-up study 3 weeks later showed diffuse subendocardial LGE in the whole left ventricle. Upon treatment with steroids, CMR-studies revealed marked reduction of subendocardial LGE after 3 months in parallel with further clinical improvement. This case therefore highlights the clinical importance of CMR to visualize the extent of endomyocardial involvement in the diagnosis and treatment of eosinophilic myocarditis.

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Figures

Figure 1
Figure 1
(A) Endomyocardial biopsy specimen. Extensive eosinophilic infiltrate involving the endocardium and myocardium (hematoxylin and eosin). Corresponding CMR short-axis slices (basal, middle, apical) during acute presentation (B), after 3 weeks (C), and after 3 months (D) showing marked regression of subendocardial LGE.
See this image and copyright information in PMC

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