[Eosinophilic endomyocarditis post partum or pregnancy-related cardiomyopathy].

Abstract

We report the case of a 28-year old asthmatic female patient, who developed an acute heart failure beginning with diarrhea, fever, and dyspnea 5 weeks after delivery. After improvement of all vital functions and dismissal from hospital care unit a marked blood hypereosinophilia, left ventricular congestive heart failure, pericardium effusion and fever up to 40 degrees C followed. Endomycardial, bone marrow and skeletal muscle biopsies and the pericardial fluid showed a marked eosinophilic infiltration or polymyositis, respectively, which could be treated successfully with steroids and azathioprin. During steroid medication cytomegalovirus-associated myocarditis developed and was diagnosed by in situ hybridization. CMV hyperimmunoglobulin treatment (Cytotect, Biotest) was started (2 ml/kg bw on day 1 and 3, and 1 ml/kg on days 5, 7 and 9), which led to the eradication of the residual infiltrate and CMV-DNA in the myocardium. After discontinuation of all medication, eosinophilia and asthma recurred so that immunosuppressive treatment was continued.

• Authors: D Gehrke, M Herzum, U Schönian, H H Klein, L Drude, H D Mennel, B Maisch
• Journal: Herz (Herz) Vol. 19 Issue 3 Pg. 176-81 (Jun 1994) ISSN: 0340-9937 [Print] Germany
• Vernacular Title: Eosinophile Endomyokarditis post partum oder Schwangerschaftskardiomyopathie.
• PMID: 7927130 (Publication Type: Case Reports, Journal Article)

Chemical References

• Immunoglobulins
• Immunoglobulins, Intravenous
• cytomegalovirus-specific hyperimmune globulin
• Azathioprine
• Prednisone

Topics

• Adult
• Azathioprine (administration & dosage)
• Biopsy
• Combined Modality Therapy
• Cytomegalovirus Infections (diagnosis, drug therapy, pathology)
• Diagnosis, Differential
• Endocardium (drug effects, pathology)
• Female
• Heart Failure (diagnosis, drug therapy, pathology)
• Humans
• Hypereosinophilic Syndrome (diagnosis, drug therapy, pathology)
• Immunoglobulins (administration & dosage)
• Immunoglobulins, Intravenous
• Myocarditis (diagnosis, drug therapy, pathology)
• Myocardium (pathology)
• Opportunistic Infections (diagnosis, drug therapy, pathology)
• Prednisone (administration & dosage)
• Pregnancy
• Pregnancy Complications, Cardiovascular (diagnosis, drug therapy, pathology)
• Puerperal Disorders (diagnosis, drug therapy, pathology)