Eosinophilic infiltration immediately following transplantation: recurrent hypersensitivity reaction?
Hypersensitivity myocarditis is a well-known complication of pharmaceutical therapy, often requiring heart transplantation. We report the unusual case of pre-transplant hypersensitivity myocarditis with eosinophilic myocardial infiltration in the donor heart, demonstrated by needle biopsy at the time of transplant ('time-zero' biopsy). At first the myocarditic process was temptatively attributed to a pre-transplant pathology in the donor heart, but the close similarity between the pre-transplant and the post-transplant infiltrate and the clinical data of an eosinophilic peak of the recipient during the transplant procedure brought to the diagnosis of early recurrent hypersensitivity myocarditis.
di Gioia
C R
CR
Department of Experimental Medicine and Pathology, La Sapienza University, Rome, Italy.
d'Amati
G
G
Grillo
P
P
Laurenti
A
A
Gallo
P
P
D000328:Adult; D001707:Biopsy, Needle; D002634:Chemotaxis, Leukocyte / Q000187:drug effects*; D004342:Drug Hypersensitivity / Q000209:etiology* / Q000473:pathology; D004802:Eosinophilia / Q000209:etiology* / Q000473:pathology; D004804:Eosinophils / Q000473:pathology*; D016027:Heart Transplantation / Q000009:adverse effects*; D006801:Humans; D008297:Male; D009205:Myocarditis / Q000139:chemically induced* / Q000473:pathology; D012008:Recurrence; D013988:Ticlopidine / Q000009:adverse effects; D014019:Tissue Donors
D013988:Ticlopidine