Eosinophilic Myocarditis due to Churg-Strauss Syndrome With Markedly Elevated Eosinophil Cationic Protein
スポンサーリンク
概要
- 論文の詳細を見る
A 67-year-old woman with asthma visited our hospital with increasing dyspnea and new-onset paresthesia and purpura in her legs. Physical examination showed a wheeze, pretibial edema, and surrounding purpura. Chest X-rays showed cardiac decompensation and an electrocardiogram revealed a new ST-T change. Laboratory data showed leukocytosis, hypereosinophilia (10,450/<I>μ</I>L), troponin T(+), elevated BNP, and markedly elevated eosinophil cationic protein (ECP) (> 150 ng/mL). Echocardiography revealed diffuse left ventricular hypokinesis (ejection fraction 30%) with increased wall thickness. Coronary angiography was normal. Cardiac magnetic resonance imaging implied diffuse myocardial edema and subendocardial late gadolinium enhancement. Skin biopsy of purpura showed superfi cial perivascular dermatitis with remarkable eosinophilic infiltrations. No evidence of drug allergies, parasitic infection, or myeloproliferative disorder was detected. Based on these findings, a diagnosis of eosinophilic myocarditis due to Churg-Strauss syndrome was considered. She was administered prednisolone at a dose of 1 mg/kg, cyclophosphamide, and diuretics. Several markers of eosinophilic myocarditis and heart failure gradually improved, including ECP. She was discharged 30 days later with no cardiac event. Eosinophilic myocarditis is characterized by predominantly eosinophilic infi ltration. Eosinophilic granule proteins, such as ECP and major basic protein, play important roles in the pathogenesis of eosinophilic myocarditis. We experienced a rare case of eosinophilic myocarditis due to Churg-Strauss syndrome. Markedly elevated ECP played an important role in the early diagnosis and subsequent reduction in ECP served as a marker of monitoring. In an asthmatic patient with dyspnea, hypereosinophilia, and vasculitis, Churg-Strauss syndrome with eosinophilic myocarditis should be considered.
著者
-
Ise Takayuki
Department of Medicine and Bioregulatory Sciences, Institute of Health Biosciences, The University o
-
Soeki Takeshi
Department of Biochemistry, National Cardiovascular Center Research Institute
-
Sata Masataka
Department Of Advanced Clinical Science And Therapeutics Graduate School Of Medicine University Of T
-
Yamada Hirotsugu
Department Of Cardiovascular Medicine Institute Of Health Bioscience Research The University Of Toku
-
Ueda Yuka
Department Of Pediatrics Kinki University School Of Medicine
-
Niki Toshiyuki
Department Of Cardiovascular Medicine Institute Of Health Biosciences The University Of Tokushima Gr
-
Tomita Noriko
Department Of Cardiovascular Medicine Institute Of Health Biosciences The University Of Tokushima Gr
-
Wakatsuki Tetsuzo
Department Of Cardiovascular Medicine Institute Of Health Biosciences The University Of Tokushima Gr
-
Iwase Takashi
Department Of Cardiovascular Medicine The University Of Tokushima Graduate School Of Health Bioscien
-
Yamaguchi Koji
Department Of Anesthesiology Nagasaki University School Of Medicine
-
Taketani Yoshio
Department Of Cardiology And Clinical Research National Hospital Organization Zentsuji Hospital
-
Bando Sachiko
Department of Cardiovascular Medicine, Tokushima University
-
Wakatsuki Tetsuzo
Department of Cardiovascular Medicine, Institute of Health Biosciences, The University of Tokushima Graduate School
-
Hara Tomoya
Department of Cardiovascular Medicine, Institute of Health Biosciences, The University of Tokushima Graduate School
-
Kadota Muneyuki
Department of Cardiovascular Medicine, Institute of Health Biosciences, The University of Tokushima Graduate School
-
Bando Mika
Department of Cardiovascular Medicine, Institute of Health Biosciences, The University of Tokushima Graduate School
-
Ogasawara Kozue
Department of Cardiovascular Medicine, Institute of Health Biosciences, The University of Tokushima Graduate School
-
Iwase Takashi
Department of Cardiovascular Medicine, Institute of Health Biosciences, The University of Tokushima Graduate School
-
Niki Toshiyuki
Department of Cardiovascular Medicine, Institute of Health Biosciences, The University of Tokushima Graduate School
-
Yamada Hirotsugu
Department of Cardiovascular Medicine, Institute of Health Biosciences, The University of Tokushima Graduate School
-
Ise Takayuki
Department of Cardiovascular Medicine, Institute of Health Biosciences, The University of Tokushima Graduate School
関連論文
- Role of Adiponectin in Preventing Vascular Stenosis : The Missing Link of Adipo-Vascular Axis
- PE-566 Variations in the Origins of Mature Smooth Muscle Cells with SM1/2 Expression in Vascular Remodeling(Development and differentiation-3 (M) PE97,Poster Session (English),The 70th Anniversary Annual Scientific Meeting of the Japanese Circulation Soci
- OE-236 Genetic Deletion of Angiotensin-converting Enzyme 2 Exacerbates Neointimal Hyperplasia after Wire-mediated Endovascular Injury with Regional Severe Inflammation(OE40,Atherosclerosis, Basic 2 (IHD),Oral Presentation (English),The 73rd Annual Scienti
- OJ-230 Recruitment of Bone-Marrow-Derived Stem Cells after Coronary Stent Implantation and Its Clinical Significance(Restenosis, basic/clinical-2 (IHD) OJ39,Oral Presentation (Japanese),The 70th Anniversary Annual Scientific Meeting of the Japanese Circul
- Infective Endocarditis Caused by Lactobacillus
- Hematopoietic stem cells differentiate into vascular progenitor cells that contribute to atherosclerosis
- Ghrelin Suppresses Cardiac Sympathetic Activity and Attenuates Early Left Ventricular Remodeling in Rats with Myocardial Infarction(Old Myocardial Infarction/Remodeling 1 (IHD), The 69th Annual Scientific Meeting of the Japanese Circulation Society)
- C-type Natriuretic Peptide, a Novel Antifibrotic Agent, Attenuates Cardiac Remodeling and Improves Left Ventricular Dysfunction in Dilated Cardiomyopathy(Cardiovascular Pharmacology, Basic/Clinical 1 (H), The 69th Annual Scientific Meeting of the Japanese
- Calcineurin-NFAT Pathway-Dependent Cardiac Remodeling in Mice Deficient for GC-A, a Receptor for Atrial and Brain Natriuretic Peptides(Cardiac Hypertrophy 1 (M), The 69th Annual Scientific Meeting of the Japanese Circulation Society)
- OE-361 Inhibitory Effect of C-Type Natriuretic Peptide (CNP) on Cultured Cardiac Myocyte Hypertrophy : Interference between CNP and Endothelin-1 Signaling Pathways(Cardiac Hypertrophy, Basic and Clinical 1 (M) : OE46)(Oral Presentation (English))