title: [Löffler fibroblastic endocarditis in the thrombotic stages in isolated right ventricular tissue eosinophilia].
abstract: We report on a male, 31 year old, Turkish patient with an intracardiac mass in the right ventricle, reduction of performance and weight, as well as intermittent fever. No eosinophilia was documented in the peripheral blood; cardiac function was primarily normal. Besides the differential diagnosis of Löffer's endocarditis (endomyocardial fibrosis) an inflammatory disease and a malignant cardiac tumor were suggested. The diagnosis of Löffler's endocarditis could not be confirmed morphologically by echocardiography nor histologically by right ventricular biopsy. Operative removal of the mass lesion was necessary because of fast tumor progression, fulminant pulmonary embolism, and infiltration of the tricuspid valve. Only then, histologically Löffler's eosinophilic endocarditis of thrombotic stage was diagnosed. Antiphlogistic therapy with cortisone was initially performed. With a dose reduction after 6 months, a relapse of the thrombotic mass occurred. Therefore, continuous treatment with cortisone and azathioprine was induced followed by further tumor regression and further clinical stabilization since 8 months of treatment.
authors.affiliation: Medizinische Universitätsklinik und Poliklinik-Innere Medizin, Bonn.
authors.forename: A
authors.initials: A
authors.lastname: Hagendorff
authors.forename: M
authors.initials: M
authors.lastname: Hümmelgen
authors.forename: H
authors.initials: H
authors.lastname: Omran
authors.forename: L
authors.initials: L
authors.lastname: Pizzulli
authors.forename: M
authors.initials: M
authors.lastname: Zirbes
authors.forename: E
authors.initials: E
authors.lastname: Bierhoff
authors.forename: T
authors.initials: T
authors.lastname: Sommer
authors.forename: U
authors.initials: U
authors.lastname: Pfeifer
authors.forename: P G
authors.initials: PG
authors.lastname: Kirchhoff
authors.forename: J
authors.initials: J
authors.lastname: Nitsch
authors.forename: B
authors.initials: B
authors.lastname: Lüderitz
mesh_terms: D000328:Adult; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage; D001379:Azathioprine / Q000008:administration & dosage; D001706:Biopsy; D003348:Cortisone / Q000008:administration & dosage; D003937:Diagnosis, Differential; D004359:Drug Therapy, Combination; D004452:Echocardiography; D004719:Endomyocardial Fibrosis / Q000175:diagnosis / Q000473:pathology / Q000628:therapy; D006801:Humans; D017681:Hypereosinophilic Syndrome / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy; D008297:Male; D009206:Myocardium / Q000473:pathology; D011655:Pulmonary Embolism / Q000175:diagnosis / Q000473:pathology / Q000628:therapy; D012008:Recurrence; D013927:Thrombosis / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy
chemical_list: D000893:Anti-Inflammatory Agents; D001379:Azathioprine; D003348:Cortisone
vernacular_title: Endokarditis fibroplastica Löffler im thrombotischen Stadium bei isolierter rechtsventrikulärer Gewebe-Eosinophilie.