title: Clinical features and outcomes of eosinophilic myocarditis patients treated with prednisolone at a single institution over a 27-year period.
abstract: BACKGROUND
  Eosinophilic myocarditis is a rare clinical entity characterized by eosinophilia and myocardial inflammation with infiltrating eosinophils. The prognosis of patients with eosinophilic myocarditis is difficult to determine due the disease's rarity and varied causes; consequently, standard treatment has not been established.
  
  
  OBJECTIVE
  To elucidate the clinical characteristics and treatment outcome of eosinophilic myocarditis, we retrospectively studied 7 patients fulfilling the criteria of the Japanese Circulation Society for eosinophilic myocarditis from among 64 patients admitted to our institution with eosinophilia over a 27-year period.
  
  
  RESULTS
  The patients' ages at diagnosis ranged from 36 to 83 years (median: 52 years). The etiologies of the eosinophilic myocarditis were found to be idiopathic (3 patients), Churg-Strauss syndrome (2 patients), parasitic infection (1 patient) and chronic eosinophilic leukemia (CEL) (1 patient). In addition to treatment for the underlying disease, we also administered prednisolone at a dose appropriate to the disease severity (6 of 7 patients). The patient who was diagnosed with a parasitic infection was treated only with albendazole, because eosinophilic myocarditis was mild. The patient with CEL was positive for the FIP1 L1-PDGFRα fusion gene and was treated with imatinib. Eosinophilic cationic protein was a useful marker for assessing disease activity and treatment efficacy. At the end of the study, of the seven patients treated, six were alive (86%), giving a mean survival time of 37 ± 40 months (mean ± SD).
  
  
  CONCLUSIONS
  Because eosinophilic myocarditis has various etiologies, it is essential to identify the etiology of the underlying disease. In the majority of eosinophilic myocarditis patients, administration of prednisolone may be an effective therapeutic modality producing a good outcome.
authors.affiliation: Department of Internal Medicine, Circulatory and Body Fluid Regulation, Faculty of Medicine, University of Miyazaki, Japan. sayakawano23@yahoo.co.jp
authors.forename: Sayaka
authors.initials: S
authors.lastname: Kawano
authors.forename: Johji
authors.initials: J
authors.lastname: Kato
authors.forename: Noriaki
authors.initials: N
authors.lastname: Kawano
authors.forename: Yuki
authors.initials: Y
authors.lastname: Yoshimura
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Masuyama
authors.forename: Takashi
authors.initials: T
authors.lastname: Fukunaga
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Sato
authors.forename: Haruhiko
authors.initials: H
authors.lastname: Maruyama
authors.forename: Kenroh
authors.initials: K
authors.lastname: Mihara
authors.forename: Akira
authors.initials: A
authors.lastname: Ueda
authors.forename: Kiyokazu
authors.initials: K
authors.lastname: Toyoda
authors.forename: Takuroh
authors.initials: T
authors.lastname: Imamura
authors.forename: Kazuo
authors.initials: K
authors.lastname: Kitamura
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001853:Bone Marrow / Q000473:pathology; D015267:Churg-Strauss Syndrome / Q000150:complications; D004802:Eosinophilia / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D005260:Female; D006801:Humans; D017681:Hypereosinophilic Syndrome / Q000150:complications; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009205:Myocarditis / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D010272:Parasitic Diseases / Q000150:complications; D011239:Prednisolone / Q000627:therapeutic use*; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D007166:Immunosuppressive Agents; D011239:Prednisolone