Boussir Hanane, Ghalem Amine, Ismaili Nabila, El Ouafi Noha
Department of Cardiology, University Hospital of Mohammed VI, Oujda, MoroccoMorocco.
J Saudi Heart Assoc. 2017 Jul;29(3):211-213. doi: 10.1016/j.jsha.2016.11.001. Epub 2016 Nov 17.
Hypereosinophilic syndrome (HES) is a heterogeneous group of hematological disorders characterized by a chronic, unexplained hypereosinophilia with tissue damage. Cardiac involvement occurs in ∼20% of patients with HES and represents a major turning point. Cardiac injuries related to eosinophilia are divided into three chronological phases: eosinophilic infiltration, thrombosis, and fibrosis. We report a case of a 33-year-old woman diagnosed with HES, with pulmonary and gastrointestinal involvement and eosinophilic myocarditis in cardiogenic shock. The evolution was favorable with dobutamine, anticoagulation, corticosteroids, and later, β-blockers and angiotensin-converting enzyme inhibitors. Cardiac involvement in HES is rare but carries a poor prognosis. Corticosteroids are considered by many to be the mainstay of treatment. Although new treatments have been suggested, only a few seem promising.
高嗜酸性粒细胞综合征（HES）是一组异质性血液系统疾病，其特征为慢性、不明原因的嗜酸性粒细胞增多并伴有组织损伤。约20%的HES患者会出现心脏受累，这是一个主要转折点。与嗜酸性粒细胞增多相关的心脏损伤可分为三个时间阶段：嗜酸性粒细胞浸润、血栓形成和纤维化。我们报告一例33岁女性，诊断为HES，伴有肺部和胃肠道受累以及心源性休克的嗜酸性粒细胞性心肌炎。在使用多巴酚丁胺、抗凝、皮质类固醇治疗后，病情好转，后期加用β受体阻滞剂和血管紧张素转换酶抑制剂。HES患者的心脏受累罕见，但预后较差。许多人认为皮质类固醇是主要治疗方法。尽管已提出新的治疗方法，但只有少数似乎有前景。
