Eosinophilic Endomyocarditis Combined With Pericardial and Pleural Effusion

Abstract

Eosinophilic endomyocarditis is a manifestation of hypereosinophilic syndrome, characterized by prolonged (>6 months), unexplained peripheral blood eosinophilia (>1,500 cells/mm3) with end-organ damage in unknown causes. We report a case of a 42-year-old patient who developed eosinophilic endomyocarditis following upper respiratory tract symptoms for 2 months. Additionally, endomyocarditis was combined with massive pleural effusion and pericardial effusion, which have not been reported in Korea.

Warfarin-Induced Eosinophilic Pleural Effusion

“…These mechanisms include hypersensitivity, allergic reaction, direct toxic effect, increased oxygen free radical production, suppression of the antioxidant defense mechanism, and chemical-induced inflammation. 4) 5) Approximately 30 drugs are believed to cause pleural disease, and development of pleural fluid eosinophilia has been reported in association with therapy with the following drugs: dantrolene, nitrofurantoin, fluoxetine, warfarin, gliclazide, propylthiouracil, isotrentinoin, mesalamine, bromocriptine, valproic acid, tinazidine, and antibiotics such as penicillin, ceftriaxone, and streptomycin. 2) 3) The presence of eosinophilia in pleural fluid may provide a clinical clue to the presence of drug-induced pleural disease but its presence or absence is not specific.…”

Eosinophilic pericardial effusion in hypereosinophilic syndrome with restrictive cardiomyopathy

“…An eosinophilic pleural effusion is the most common reported type, whereas an eosinophilic pericardial effusion and ascites are seldom described . An eosinophilic pericardial effusion is clinically more important because it is a sign of a life‐threatening cardiac damage in the form of eosinophilic myocarditis with secondary eosinophilic pericarditis . Differential diagnoses include parasitic infestations, drugs, hypereosinophilic syndrome, Churg–Strauss syndrome, and restrictive cardiomyopathy .…”

“…An eosinophilic pericardial effusion is clinically more important because it is a sign of a life‐threatening cardiac damage in the form of eosinophilic myocarditis with secondary eosinophilic pericarditis . Differential diagnoses include parasitic infestations, drugs, hypereosinophilic syndrome, Churg–Strauss syndrome, and restrictive cardiomyopathy . HES is a rare leucoproliferative disorder of unknown aetiology with infrequent pericardial involvement.…”