Hypereosinophilic syndrome with isolated Loeffler's endocarditis: complete resolution with corticosteroids.
Hypereosinophilic syndrome (HES) is classically defined as prolonged, unexplained peripheral eosinophilia in a patient presenting with evidence of end-organ damage. The heart is involved in two forms; endomyocardial fibrosis (Davies disease) and eosinophilic endocarditis (Loffler's endocarditis). It was first reported in 1968 by Hard and Anderson. Chusid and co-workers formulated a definition with strict criteria for the diagnosis of HES as 1) peripheral blood eosinophilia more than 1500 cells/cu mm for at least six months duration 2)signs, symptoms of end-organ (heart, lungs, gastrointestinal tract, skin, bone-marrow, brain) involvement with eosinophil tissue infiltration/injury 3) exclusion of known secondary causes of eosinophilia. We report a case of hypereosinophilic syndrome with Loffler's endocarditis, in the absence of endomyocardial fibrosis. The patient presented with a eosinophilic vegetation over the posterior leaflet of the mitral valve. There was complete resolution of the vegetation after two months of corticosteroid therapy.
Sen
T
T
Department of Pulmonology, PD Hinduja National Hospital and Medical Research Centre, Mahim, Mumbai - 400016, India.
Ponde
C K
CK
Udwadia
Z F
ZF
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use*; D000328:Adult; D003937:Diagnosis, Differential; D004696:Endocarditis / Q000150:complications* / Q000175:diagnosis; D006801:Humans; D017681:Hypereosinophilic Syndrome / Q000150:complications* / Q000188:drug therapy* / Q000503:physiopathology; D008297:Male; D008943:Mitral Valve / Q000503:physiopathology; D016896:Treatment Outcome
D000305:Adrenal Cortex Hormones