Eozinofil – „dobrý sluha, zlý pán“ / Eosinophil – “a good servant but a bad master”

Q4 Medicine Cardiology Letters Pub Date : 2021-01-01 DOI:10.4149/CARDIOL_2021_1_10
V. Simovicova, M. Danková, M. Luknár, P. Leśny, V. Lauko, P. Talarcik, E. Goncalvesová
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Abstract

Simovicova V, Dankova M, Luknar M, Lesny P, Lauko V, Talarcik P, Gonçalvesova E. Eosinophil – “a good servant but a bad master”. Cardiology Lett. 2021;30(1):57–61 Abstract. Eosinophilic myocarditis (EM) is a rare form of myocarditis with a very heterogeneous etiology. It is characterized by the presence of eosinophilic infiltrate in the myocardium. The course can vary from an asymptomatic clinical picture to life-threatening conditions. We describe a case of a 29-year-old patient with a history of bronchial asthma hospitalized for chestpain and manifesting heart failure. A moderate decrease of ejection fraction of the undilated left ventricle chamber was found. High levels of troponin, NTproBNP and eosinophilia were present in the laboratory findings. By endomyocardial biopsy we confirmed the presence of an eosinophilic infiltrate with a histological pattern of myocarditis. We did not confirm clonal proliferation of eosinophils. Corticoid therapy was initiated. After a week we observed normalization of eosinophils and a decrease in cardiac specific enzymes. Different types of ventricular tachycardias, which required multiple external defibrilation, occured during treatment. An ICD was implanted in the secondary prevention of sudden cardiac death. Ventricular arrhythmias have been stabilized by a combination of pharmacotherapy and individualized programming of ICD functions. Control biopsy was without histological finding of myocarditis. Left ventricular ejection fraction improved by 10%: the patient has been asymptomatic. Eosinophilic myocarditis is a rare disease but with poor prognosis in the acute phase. With the presence of eosinophilia in peripheral blood, this potential cause of acute heart failure should also be considered. Clear diagnosis must be confirmed by endomyocardial biopsy. The basis of treatment is corticoid therapy, which positively affects survival. Fig. 4, Tab. 1, Ref. 13, on-line full text (Free, PDF) www.cardiologyletters.sk
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Eozinofil -“dobrý sluha, zlý pán”/嗜酸性粒细胞-“好仆人,坏主人”
Simovicova V, Dankova M, Luknar M, Lesny P, Lauko V, Talarcik P, gonalalvesova E.嗜酸性细胞-“好仆人,坏主人”。心脏病杂志,2021;30(1):57-61嗜酸性心肌炎(EM)是一种罕见的形式的心肌炎非常异质性的病因。其特点是心肌中存在嗜酸性粒细胞浸润。病程可以从无症状的临床表现到危及生命的情况。我们描述一个病例29岁的患者支气管哮喘病史住院胸痛和表现心力衰竭。未扩张左心室的射血分数有中度下降。高水平的肌钙蛋白,NTproBNP和嗜酸性粒细胞存在于实验室结果。通过心肌内膜活检,我们证实存在嗜酸性粒细胞浸润,组织学模式为心肌炎。我们没有证实嗜酸性粒细胞的克隆性增殖。开始皮质激素治疗。一周后,我们观察到嗜酸性粒细胞的正常化和心脏特异性酶的减少。治疗期间出现了不同类型的室性心动过速,需要多次体外除颤。在心脏性猝死二级预防中植入ICD。通过药物治疗和ICD功能的个性化编程相结合,室性心律失常已经稳定下来。对照组活检未发现心肌炎。左心室射血分数提高10%:患者无症状。嗜酸性心肌炎是一种罕见的疾病,急性期预后较差。随着外周血中嗜酸性粒细胞增多,急性心力衰竭的潜在原因也应予以考虑。明确的诊断必须通过心内膜肌活检证实。治疗的基础是皮质激素治疗,它对生存有积极的影响。图4,表1,参考文献13,在线全文(免费,PDF) www.cardiologyletters.sk
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来源期刊
Cardiology Letters
Cardiology Letters Medicine-Cardiology and Cardiovascular Medicine
CiteScore
0.20
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0.00%
发文量
7
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