Persistent Eosinophilic Infiltration of the Myocardium in a Child in Complete Remission of Acute Lymphoblastic Leukemia and Eosinophilia. Potential Role in Late Cardiac Disease?

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概要

• 論文の詳細を見る

• This report describes the long-term (23 years) follow-up of a pediatric patient with acute lymphoblastic leukemia and eosinophilia who underwent multiple valve replacements. An 8-year-old boy with this complex disease was admitted in January 1984 and treated with 6-week course of vincristine, L-asparaginase, and prednisolone, which induced complete remission. He developed atrioventricular valvular insufficiency and infectious endocarditis at 13.5 and 17.3 years of ages, respectively, with progressive development of congestive heart failure. At 18.6 years of age, he underwent prosthetic valve replacement of both atrioventricular valves; the mitral valve was replaced with a mechanical prosthetic valve and tricuspid valve with a bioprosthetic valve. Histopathological examination of the ventricular endomyocardium showed extensive fibrous degeneration and persistent infiltration of eosinophils and lymphocytes. The right-side prosthesis was replaced twice, at 22.4 and 29 years of ages, due to degeneration of bioleaflets and thrombosis of the mechanical valve, respectively. Although he tolerated all surgical procedures, he developed liver cancer at 31 years of age and died. Autopsy could not be performed. The present study indicates that a subset of patients in complete remission of acute lymphoblastic leukemia and eosinophilia can show persistent myocardial eosinophilic infiltration and are at risk of late cardiac disease.

• The Keio Journal of Medicineの論文

著者

• Suzuki Satoru

  Department of Aging Medicine and Geriatrics, Shinshu University, Graduate School of Medicine

• SATO Seiji

  Department of Chemistry, Faculty and Graduate School of Sciences, Kyushu University

• Kanki Hideaki

  Saitama Municipal Hospital Saitama Jpn

• Kanki Hideaki

  Department Of Cardiology Saitama Municipal Hospital

• Tsuji Atsutoshi

  Department of Pediatrics, Saitama Municipal Hospital

• Sasaki Michiko

  Department of Pediatrics, Saitama Municipal Hospital

• Ishii Toru

  Department of Pediatrics, Saitama Municipal Hospital

• Takeuchi Shigeyuki

  Saitama Cardiovascular and Respiratory Center

• Fukuda Toyoki

  Tokyo Metropolitan Kiyose Childrens Hospital

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