title: [Differential diagnostic considerations in eosinophilia with reference to a 19-year-old patients with Löffler endocarditis].
abstract: In this case report a 19-year-old girl suffering from hypereosinophilia with 3500 cells/mm3 and involvement of the right lung, lymph nodes, skin, serosa and heart is described. Within 10 days of admission an infiltration of the right upper lung lobe disappeared spontaneously and was diagnosed as transient eosinophilic lung infiltration according to Löffler. Both lymph node needle biopsy and several skin biopsies revealed merely general reactive changes whereas a bronchial lavage produced a significant number of eosinophilic granulocytes. Autoimmunologic or infectious-toxic disorders were ruled out as etiologic causes. Within 4 weeks after admission severe mitral and tricuspidal insufficiency as well as AV-block second grade and protodiastolic galloping rhythm developed in addition to progressing polyserositis. The echocardiographic pattern was in accordance with restrictive endocarditis. Due to the greatly reduced left ventricular ejection fraction cortisone (125 mg prednison equivalent) was tentatively administered as therapy. Within 2 weeks heart-, serosa- and lymph-node-findings became normal as well as the eosinophilic count, the scaling skin rash being only partly improved. After 10 months of continuous cortisone therapy (10 mg prednison equivalent) the patient was without evidence of disease. However in conclusion, it may be said that such pattern of findings suggests a hypereosinophilic syndrome with Löffler endocarditis with an unknown future course of disease although generally survival prognosis may not be too high.
authors.affiliation: Medizinischen Universitätsklinik, Graz.
authors.forename: B
authors.initials: B
authors.lastname: Eber
authors.forename: P
authors.initials: P
authors.lastname: Schnider
authors.forename: A
authors.initials: A
authors.lastname: Tiran
authors.forename: M
authors.initials: M
authors.lastname: Marak
authors.forename: M
authors.initials: M
authors.lastname: Samitz
authors.forename: W
authors.initials: W
authors.lastname: Domej
authors.forename: F
authors.initials: F
authors.lastname: Aglas
mesh_terms: D000328:Adult; D003937:Diagnosis, Differential; D004696:Endocarditis / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology; D005260:Female; D006801:Humans; D007958:Leukocyte Count / Q000187:drug effects; D008134:Long-Term Care; D011241:Prednisone / Q000008:administration & dosage; D011657:Pulmonary Eosinophilia / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology
chemical_list: D011241:Prednisone
vernacular_title: Differentialdiagnostische Uberlegungen zur Eosinophilie anhand einer 19jährigen Patientin mit Löfflerscher Endokarditis.