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嗜酸性粒细胞性心肌炎的临床病理特征

The Clinicopathological Profile of Eosinophilic Myocarditis.

作者信息

Sheikh Haris, Siddiqui Mahrukh, Uddin Syed Mohammad Mazhar, Haq Aatera, Yaqoob Uzair

机构信息

Internal Medicine, Civil Hospital, Karachi, PAK.

Surgery, Civil Hospital, Karachi, PAK.

出版信息

Cureus. 2018 Dec 3;10(12):e3677. doi: 10.7759/cureus.3677.

Abstract

Eosinophilic myocarditis (EM) is a rare form of myocarditis. As there is extreme diversity in its manifestations, the true incidence is difficult to assess and no proper epidemiological criteria are present. It generally presents with a wide array of clinical manifestations. Clinical presentation tends to differ in cases and not all the patients show the same signs and symptoms. The etiology of EM often remains obscure but potential causes have been identified which may include hypersensitivity to drugs, exposure to certain viruses and parasites, and hyper-eosinophilic syndromes. Endomyocardial biopsy is considered to be a gold standard for the diagnosis of EM. Echocardiography, cardiac magnetic resonance, and bio markers particularly serum eosinophilic cationic protein concentrations are also known to aid in diagnosis. EM may lead to progressive, irreversible, and fatal myocardial damage if prompt diagnosis is not made and therapy is not initiated. The current treatment regimens include corticosteroids, cytotoxic agents, and immunosuppressive therapy. However, a proper treatment criterion is yet to be established.

摘要

嗜酸性粒细胞性心肌炎(EM)是心肌炎的一种罕见形式。由于其表现极为多样,真正的发病率难以评估,且尚无合适的流行病学标准。它通常表现出各种各样的临床表现。不同病例的临床表现往往有所不同,并非所有患者都有相同的体征和症状。EM的病因常常不明,但已确定了一些潜在病因,可能包括药物过敏、接触某些病毒和寄生虫以及高嗜酸性粒细胞综合征。心内膜心肌活检被认为是诊断EM的金标准。超声心动图、心脏磁共振成像以及生物标志物,特别是血清嗜酸性粒细胞阳离子蛋白浓度,也有助于诊断。如果不及时诊断和开始治疗,EM可能会导致进行性、不可逆且致命的心肌损伤。目前的治疗方案包括使用皮质类固醇、细胞毒性药物和免疫抑制疗法。然而,尚未建立适当的治疗标准。

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