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The significance of early screening with echocardiography in eosinophilic granulomatosis with polyangiitis

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Abstract

Löffler endocarditis is a serious complication of idiopathic hypereosinophilic syndrome characterized by a peculiar type of fibrosing endocarditis. It results in heart failure due to restrictive cardiomyopathy and systemic embolism due to intracardiac thrombus. Here we present a case of a 57-year-old man with Löffler endocarditis concomitant with eosinophilic granulomatosis with polyangiitis. A thrombus in the left ventricular apex was noted on transthoracic echocardiography performed as a screening of left ventricular dilatation, which seemed to be a typical finding of Löffler endocarditis. But there were no findings that indicated restrictive cardiomyopathy. He was diagnosed with Löffler endocarditis at the thrombotic stage and was given methylprednisolone. The thrombus got markedly smaller within 1 month after initiation of the medical treatment. He has been doing well for more than 2 years since then without eosinophilia or left ventricular thrombosis. In the present case, we could successfully detect the thrombus in the left ventricular apex with echocardiography before the occurrence of embolism and provide early medical treatment. Early detection and initiation of medical treatment are extremely important to treat this unusual but often life-threatening condition because methylprednisolone is effective in the necrotic stage and thrombotic stage.

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Authors and Affiliations

  1. Department of Cardiology, Hino Municipal Hospital, 4-3-1, Tamadaira, Hino, Tokyo, 191-0062, Japan

    Toshimitsu Tsugu

  2. Department of Cardiology, Sakakibara Heart Institute, Fuchu, Japan

    Toshimitsu Tsugu, Yuji Nagatomo & Keitaro Mahara

  3. Department of Radiology, School of Medicine, Keio University, Tokyo, Japan

    Yoshitake Yamada

  4. Department of Radiology, Hino Municipal Hospital, Hino, Japan

    Hiroshi Miura

  5. Department of Laboratory Medicine, School of Medicine, Keio University, Tokyo, Japan

    Mitsushige Murata

Authors
  1. Toshimitsu Tsugu
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  2. Yuji Nagatomo
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  3. Yoshitake Yamada
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  4. Keitaro Mahara
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  5. Hiroshi Miura
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  6. Mitsushige Murata
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Corresponding author

Correspondence to Toshimitsu Tsugu.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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Tsugu, T., Nagatomo, Y., Yamada, Y. et al. The significance of early screening with echocardiography in eosinophilic granulomatosis with polyangiitis. J Med Ultrasonics 43, 527–531 (2016). https://doi.org/10.1007/s10396-016-0728-7

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  • DOI: https://doi.org/10.1007/s10396-016-0728-7

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