Diagnosis and treatment of eosinophilic myocarditis

Abstract

Eosinophilic myocarditis is a type of inflammatory cardiomyopathy characterized by eosinophilic infiltration into myocardial tissue. The accurate myocarditis incidence rate is difficult to determine because of the clinical limitations of an endomyocardial biopsy. The primary pathogenesis of eosinophilic myocarditis is the release of related substances by eosinophils, leading to cell membrane damage and cell destruction. However, evidence suggests that specific genes play a role in myocarditis development.As CMR imaging availability increases, the diagnosis rate of eosinophilic myocarditis will increase. The diagnosis of myocarditis mainly depends on an endocardial biopsy. Glucocorticoids can relieve patients' symptoms, but the early use of steroids may prevent intermediate disease stage development (i.e., thrombonecrosis and fibrosis with wall thrombosis). Anticoagulant therapy may also affect disease development. In addition to routine follow-up, a regular myocardial biopsy should be considered for discharged patients, if possible.

Keywords: ANCA, anti-neutrophil cytoplasmic antibody; CEL, chronic eosinophilic leukemia.; CMR, cardiac magnetic resonance; Cardiac magnetic resonance; EAM, experimental autoimmune myocarditis; ECG, electrocardiogram; ECP, eosinophilic cationic protein; EGE, early gadolinium enhancement, LGE, late gadolinium enhancement; EGPA, eosinophilic granulomatosis with polyangiitis; EMB, endomyocardial biopsy; Endomyocardial biopsy; Eosinophilic myocarditis; FIP1L1-PDGFRA, FIP1-like1-platelet-derived growth factor receptor α; Glucocorticoids; HES, hypereosinophilic syndrome; IFNγ, interferon gamma.