title: [Immunsuppressive therapy in virus-negative eosinophilic inflammatory cardiomyopathy].
abstract: METHODS
  A 52 year-old women presented with long-standing dyspnoea at exercise as a symptom of heart failure. A coronary heart disease had been excluded by coronary angiography a year before. The symptoms had persisted despite application of guideline-based anticongestive medication.
  
  
  METHODS
  Electrocardiography showed sinus rhythm with decreased anterior wall amplitudes without acute ischemic signs. The white blood count revealed elevated leucocytes with high numbers of eosinophilic granulocytes. Echocardiography demonstrated severe left ventricular dysfunction with an ejection fraction of 30 % and a left ventricular end-diastolic diameter of 75 mm. Magnetic resonance imaging showed a pathologic late enhancement in the left ventricular wall. Six myocardial biopsies were obtained and revealed virus-negative eosinophilic inflammatory cardiomyopathy with focal fibrotic scarring.
  
  
  METHODS
  The patient was treated according to a previously published study on virus-negative inflammatory heart disease with prednisone 1 mg/kg daily for 4 weeks followed by 0.33 mg/kg daily for 5 month and azathioprine 2 mg/kg daily for 6 month. The echocardiography of the left ventricular function showed an increase from 30 to 45 % and the clinical symptoms of the heart failure resolved to NYHA II.
  
  
  CONCLUSIONS
  In patients with virus-negative eosinophilic inflammatory cardiomyopathy standardized therapy with prednisone and azathioprine can improve LV function and clinical symptoms.
authors.affiliation: Medizinische Klinik 1, St. Bernward Krankenhaus Hildesheim.
authors.forename: K
authors.initials: K
authors.lastname: Möller
authors.forename: K
authors.initials: K
authors.lastname: Klingel
authors.forename: U
authors.initials: U
authors.lastname: Kaiser
authors.forename: M
authors.initials: M
authors.lastname: Thum
authors.forename: A
authors.initials: A
authors.lastname: Bönig
authors.forename: R
authors.initials: R
authors.lastname: Kandolf
authors.forename: G
authors.initials: G
authors.lastname: Hasenfuss
authors.forename: K H
authors.initials: KH
authors.lastname: Scholz
mesh_terms: D001379:Azathioprine / Q000009:adverse effects / Q000627:therapeutic use*; D001706:Biopsy; D002303:Cardiac Output, Low / Q000175:diagnosis / Q000188:drug therapy / Q000473:pathology / Q000503:physiopathology; D017147:Defibrillators, Implantable; D004562:Electrocardiography / Q000187:drug effects; D004802:Eosinophilia / Q000175:diagnosis / Q000188:drug therapy* / Q000473:pathology / Q000503:physiopathology; D005260:Female; D006333:Heart Failure / Q000175:diagnosis / Q000188:drug therapy / Q000473:pathology / Q000503:physiopathology; D006801:Humans; D007091:Image Processing, Computer-Assisted; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000627:therapeutic use*; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D009205:Myocarditis / Q000175:diagnosis / Q000188:drug therapy* / Q000473:pathology / Q000503:physiopathology; D009206:Myocardium / Q000473:pathology; D011241:Prednisone / Q000009:adverse effects / Q000627:therapeutic use*; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis / Q000188:drug therapy / Q000473:pathology / Q000503:physiopathology
chemical_list: D007166:Immunosuppressive Agents; D001379:Azathioprine; D011241:Prednisone