Li Haiying, Dai Zhenyu, Wang Binqiao, Huang Weijian
Department of Cardiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, China.
BMC Cardiovasc Disord. 2015 Feb 26;15:15. doi: 10.1186/s12872-015-0003-7.
Eosinophilic myocarditis (EM) is a relatively rare condition that may result from parasitic infections and allergic disease. Antituberculosis drugs may lead to focal myocardial infiltration by eosinophils (eosinophilic myocarditis). Symptoms may be severe, and, lead to rapidly-fatal outcomes. Early diagnosis and high-dose corticosteroids are the cornerstone of treatment, and, may lead to restoration of cardiac function with full recovery.
We report a case of eosinophilic myocarditis secondary to eosinophilia caused by antituberculosis drugs with markedly elevated ECP, focal eosinophilic infiltration in CMR imaging and endomyocardial biopsy. Finally, high-dose corticosteroids were used to reverse the cardiac injury and to improve the clinical outcome.
Antituberculosis drugs can cause eosinophilic infiltration of, and damage to, the myocardium leading to rapid progression of the clinical symptoms. Myocardial biopsy is helpful in diagnosing the disease in the early stages and high-dose corticosteroids effectively improves the prognosis of this disease.
嗜酸性粒细胞性心肌炎（EM）是一种相对罕见的疾病，可能由寄生虫感染和过敏性疾病引起。抗结核药物可能导致嗜酸性粒细胞局灶性浸润心肌（嗜酸性粒细胞性心肌炎）。症状可能很严重，并可能导致迅速致命的后果。早期诊断和大剂量皮质类固醇是治疗的基石，可能使心脏功能恢复并完全康复。
我们报告一例由抗结核药物引起的嗜酸性粒细胞增多继发嗜酸性粒细胞性心肌炎病例，该病例的嗜酸性粒细胞阳离子蛋白（ECP）显著升高，心脏磁共振成像（CMR）和心内膜活检显示局灶性嗜酸性粒细胞浸润。最后，使用大剂量皮质类固醇来逆转心脏损伤并改善临床结局。
抗结核药物可导致心肌嗜酸性粒细胞浸润和损伤，导致临床症状迅速进展。心肌活检有助于早期诊断该病，大剂量皮质类固醇可有效改善该病的预后。
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