Alam Amit, Thampi Shankar, Saba Shahryar G, Jermyn Rita
Division of Cardiovascular Diseases and Hypertension, Department of Medicine, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA.
Department of Internal Medicine, Hofstra Northwell School of Medicine, Manhasset, NY, USA.
Clin Med Insights Case Rep. 2017 Aug 30;10:1179547617723643. doi: 10.1177/1179547617723643. eCollection 2017.
Loeffler endocarditis is a rare restrictive cardiomyopathy caused by abnormal endomyocardial infiltration of eosinophils, with subsequent tissue damage from degranulation, eventually leading to fibrosis. Although an uncommon entity, it is still a disease with significant morbidity and mortality. Often identified only at late stages, treatment options are limited once fibrosis occurs, usually requiring heart failure medications or surgical intervention. We present a unique case of a woman with remote history of hypereosinophilic syndrome, attributed to treatment of rheumatoid arthritis with infliximab, who presented with symptoms of heart failure refractory to medical management and was found to have Loeffler endocarditis. The severe progression of the disease required surgical intervention with endocardial stripping to treat the right-sided diastolic heart failure.
吕弗勒心内膜炎是一种罕见的限制性心肌病，由嗜酸性粒细胞异常浸润心内膜引起，随后因脱颗粒导致组织损伤，最终导致纤维化。尽管这是一种罕见病症，但仍是一种具有较高发病率和死亡率的疾病。该病通常在晚期才被发现，一旦发生纤维化，治疗选择有限，通常需要使用心力衰竭药物或进行手术干预。我们报告了一例独特病例，一名有过嗜酸性粒细胞增多综合征病史的女性，病因是使用英夫利昔单抗治疗类风湿关节炎，她出现了药物治疗难治的心力衰竭症状，经检查发现患有吕弗勒心内膜炎。疾病的严重进展需要进行心内膜剥脱手术来治疗右侧舒张性心力衰竭。
