Clinical Features and Outcomes of Eosinophilic Myocarditis Patients Treated with Prednisolone at a Single Institution Over a 27-Year Period
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概要
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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 diseases 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). Conclusion 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.
著者
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KATO Johji
Frontier Science Research Center
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Yoshimura Yuki
Department of Cardiology, Kawasaki Medical School Hospital
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Imamura Takuroh
Department Of Internal Medicine Circulatory And Body Fluid Regulation University Of Miyazaki
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Fukunaga Takashi
Department Of Cardiology Miyazaki Prefecture Miyazaki Hospital
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Ueda Akira
Department Of Applied Mathematics And Physics Faculty Of Engineering Kyoto University
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Toyoda Kiyokazu
Department Of Surgery Miyazaki Prefectural General Hospital
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Masuyama Hiroyuki
Department Of Internal Medicine Circulatory And Body Fluid Regulation Faculty Of Medicine University
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Maruyama Haruhiko
Department Of Bioscience Department Of Cardiovascular Surgery
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Kitamura Kazuo
Department Of Applied Mathematics Osaka Kyoiku University
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Kawano Sayaka
Department Of Internal Medicine Miyazaki Prefectural Miyazaki Hospital
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Kawano Noriaki
Department Of Hematology Harasanshin Hospital
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SATO Yuichiro
Department of 1ST Pathology, Faculty of Medicine, University of Miyazaki
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Kato Johji
Frontier Science Research Center, University of Miyazaki, Japan
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Mihara Kenroh
Department of Clinical Laboratory, Miyazaki Prefectural Hospital, Japan
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Masuyama Hiroyuki
Department of Cardiology, Miyazaki Prefectural Hospital, Japan
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Maruyama Haruhiko
Department of Parasitology, Faculty of Medicine, University of Miyazaki, Japan
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Fukunaga Takashi
Department of Cardiology, Miyazaki Prefectural Hospital, Japan
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Toyoda Kiyokazu
Department of Surgery, Miyazaki Prefectural Hospital, Japan
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