title: Hypereosinophilic syndrome with cardiac involvement in a pregnant patient with multiple sclerosis.
abstract: In hypereosinophilic syndrome, the sustained overproduction of eosinophils leads to the dysfunction of one or more organs. Symptoms vary in accordance with which organ is affected. Cardiac involvement leads to substantial morbidity and to most of the deaths that are associated with hypereosinophilic syndrome.Herein, we present the case of a 31-year-old woman, pregnant for 12 weeks and with a history of multiple sclerosis, who presented with transient vision loss and splinter hemorrhages in her fingernail beds. The diagnosis was hypereosinophilic syndrome with cardiac involvement. Echocardiography revealed 2 echodense structures: one that obliterated the left ventricular apex, and another in the basal lateral wall. The patient underwent therapy with prednisone and heparin but developed heparin-induced thrombocytopenia. This condition resolved when argatroban was substituted for heparin. Two weeks after the patient's release from the hospital, echocardiography revealed improvement in the echodense ventricular structures. The transient vision loss and the splinter hemorrhages were attributed to the hypereosinophilic syndrome.We believe that this is the 1st report of a pregnant patient with hypereosinophilic syndrome and cardiac involvement.
authors.affiliation: Division of Cardiology, Loyola University Medical Center, Maywood, Illinois 60153, USA. adarki@lumc.edu
authors.forename: Amir
authors.initials: A
authors.lastname: Darki
authors.forename: Preeti P
authors.initials: PP
authors.lastname: Kodali
authors.forename: John P
authors.initials: JP
authors.lastname: McPheters
authors.forename: Harkiran
authors.initials: H
authors.lastname: Virk
authors.forename: Minesh R
authors.initials: MR
authors.lastname: Patel
authors.forename: William
authors.initials: W
authors.lastname: Jacobs
mesh_terms: D000328:Adult; D000925:Anticoagulants / Q000009:adverse effects; D001120:Arginine / Q000031:analogs & derivatives; D057915:Drug Substitution; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D006493:Heparin / Q000009:adverse effects; D006801:Humans; D017681:Hypereosinophilic Syndrome / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D009103:Multiple Sclerosis / Q000150:complications*; D010875:Pipecolic Acids / Q000627:therapeutic use; D011241:Prednisone / Q000627:therapeutic use; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D013449:Sulfonamides; D013921:Thrombocytopenia / Q000139:chemically induced; D016896:Treatment Outcome
chemical_list: D000925:Anticoagulants; D005938:Glucocorticoids; D010875:Pipecolic Acids; D013449:Sulfonamides; D006493:Heparin; D001120:Arginine; C031942:argatroban; D011241:Prednisone