title: An unusual case of recurrent Loffler endomyocarditis of the aortic valve.
abstract: Idiopathic hypereosinophilic syndrome is a rare systemic disease with an unexplained elevated eosinophil count. Loffler endomyocarditis is hypereosinophilic syndrome with endocardial fibrosis and restrictive cardiomyopathy. The atrioventricular valves are frequently involved, causing valvular regurgitation. Previously, there has been one case report of combined aortic and mitral valve involvement with Loffler endomyocarditis that was treated with bivalvular replacement. We describe a previously healthy 50-year-old man diagnosed with Loffler endomyocarditis complicated by peripheral thromboembolism and severe aortic regurgitation due to valve fibrosis and fibrotic vegetation on the aortic valve. He underwent embolectomy and aortic valve replacement in addition to treatment for his hypereosinophilia. He later presented with cardiomyopathy with severe aortic insufficiency due to the destruction of the aortic valve prosthesis by sterile fibrinous vegetation. To our knowledge, this is the second case in the literature in which Loffler endomyocarditis involves the aortic valve and the first patient in whom only the aortic valve is involved.
authors.affiliation: Department of Medicine, Division of Cardiology, Loyola University Medical Center, Maywood, Ill 60153-5590, USA. steinargud@yahoo.com or sgudmun@lumc.edu
authors.forename: G Steinar
authors.initials: GS
authors.lastname: Gudmundsson
authors.forename: Joseph
authors.initials: J
authors.lastname: Ohr
authors.forename: Ferdinand
authors.initials: F
authors.lastname: Leya
authors.forename: William R
authors.initials: WR
authors.lastname: Jacobs
authors.forename: John E
authors.initials: JE
authors.lastname: Godwin
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Schwartz
mesh_terms: D001021:Aortic Valve / Q000473:pathology* / Q000601:surgery; D001022:Aortic Valve Insufficiency / Q000209:etiology / Q000601:surgery; D020878:Device Removal / Q000009:adverse effects / Q000379:methods; D004696:Endocarditis / Q000150:complications / Q000175:diagnosis* / Q000628:therapy; D004719:Endomyocardial Fibrosis / Q000150:complications / Q000175:diagnosis; D017809:Fatal Outcome; D006349:Heart Valve Diseases / Q000175:diagnosis* / Q000601:surgery / Q000628:therapy; D006350:Heart Valve Prosthesis / Q000009:adverse effects; D006801:Humans; D017681:Hypereosinophilic Syndrome / Q000150:complications / Q000175:diagnosis; D008297:Male; D008875:Middle Aged; D011475:Prosthesis Failure; D035583:Rare Diseases / Q000150:complications / Q000175:diagnosis / Q000601:surgery; D012008:Recurrence