Reversible Severe Eosinophilic Endomyocardial Fibrosis During Pregnancy: A Case Report.
Idiopathic hypereosinophilic syndrome (HES) is a condition of unknown origin characterized by clinical manifestations attributable to eosinophilia and eosinophilic infiltration of tissues. Cardiac involvement is rare and threatening accounting for 33% to 43% of death in HES. Management of pregnant patients with HES is challenging and have rarely been reported, particularly in the setting of heart failure.We here report on the case of a 29-year-old woman with HES who developed severe endomyocardial fibrosis with heart failure during pregnancy. Outcome was favorable under treatment with prednisone and azathioprine.This case illustrates a favorable outcome of endomyocardial fibrosis during pregnancy.
From the Service de Médecine Interne 2 (MPdC, JH, ZA, FCA), Institut E3M, Centre National de Référence Lupus Systémique, Syndrome des Anticorps Anti-Phospholipides et Maladies Auto-Immunes Systémiques Rares, Hôpital de la Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, France; Université Pierre et Marie Curie (MPdC, DV-B, PCluzel, JH, ZA, FCA), Sorbonnes Universités, Paris, France; Centre de Référence Maladies Cardiaques Héréditaires (PCharron), ICAN, Inserm UMR_1166, Hôpital de la Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, Paris, France; Université de Versailles-Saint Quentin (PCharron), Hôpital Ambroise Paré, Assistance Publique-Hôpitaux de Paris, Boulogne-Billancourt, France; Service de Gynécologie Obstétrique (DV-B), Hôpital de la Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, Paris, France; Département d'Imagerie Cardiovasculaire et de Radiologie Interventionnelle (PCluzel), Hôpital de la Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, Paris, France; Institut National de la Santé et de la Recherche Médicale (PCluzel), INSERM-CNRS-LIB, Paris, France; Service de Médecine Interne (JEK), Hôpital Foch, Suresnes, France; and French Eosinophil Network (JEK), Institut d'Immunologie, Université de Lille, Lille, France.
Marc
M
Pineton de Chambrun
Philippe
P
Charron
Danièle
D
Vauthier-Brouzes
Philippe
P
Cluzel
Julien
J
Haroche
Jean-Emmanuel
JE
Kahn
Zahir
Z
Amoura
Fleur Cohen
FC
Aubart
D000328:Adult; D001379:Azathioprine / Q000627:therapeutic use; D004719:Endomyocardial Fibrosis / Q000188:drug therapy / Q000209:etiology*; D005260:Female; D006333:Heart Failure / Q000188:drug therapy / Q000209:etiology*; D006801:Humans; D017681:Hypereosinophilic Syndrome / Q000150:complications*; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D011241:Prednisone / Q000627:therapeutic use; D011247:Pregnancy
D007166:Immunosuppressive Agents; D001379:Azathioprine; D011241:Prednisone