Eosinophilic myocarditis: case series and literature review

Abstract

Eosinophilic myocarditis is a condition resulting from various eosinophilic diseases, including helminth infection, drug hypersensitivity, systemic vasculitis or idiopathic hypereosinophilic syndromes. Clinical manifestations of eosinophilic myocarditis may vary from early necrosis to endomyocardial fibrosis. Eosinophilic myocarditis is one of the most fatal complications of hypereosinophilia. However, eosinophilic myocarditis has been rarely reported in the literature, particularly in Asia Pacific regions, reflecting the under-recognition of the disease among clinicians. Early recognition is crucial for improving clinical outcomes of eosinophilic myocarditis. Early administration of systemic corticosteroid is necessary in eosinophilic myocarditis regardless of underlying causes, as delayed treatment may result in fatal outcomes. In addition, differential diagnoses of underlying causes for eosinophilia are necessary to improve long-term outcomes.

Keywords: Hypereosinophilic syndrome; Myocarditis; Toxocariasis.

Fig. 1. Endomyocardial biopsy specimen shows diffuse inflammatory cell infiltration (A: H&E, ×200) and myocardial disarray (B: H&E, ×400). Eosinophil infiltration was depicted by arrowheads.