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嗜酸性粒细胞性心肌炎导致室性心动过速风暴。

Eosinophilic Myocarditis Resulting in Ventricular Tachycardia Storm.

作者信息

Hengst Dylan, Kandah Daniel, Dervesh Ravinder, Ellerman Michael, Ugwu Justin, Goerbig-Campbell Jennifer, Campbell Dwayne

机构信息

Internal Medicine, MercyOne Des Moines Medical Center, Des Moines, USA.

Cardiology, MercyOne Des Moines Medical Center, Des Moines, USA.

出版信息

Cureus. 2024 Mar 23;16(3):e56779. doi: 10.7759/cureus.56779. eCollection 2024 Mar.

Abstract

Eosinophilic myocarditis (EM) is a rare but potentially fatal complication of sustained eosinophilia that is characterized by eosinophilic infiltration into myocardial tissue. There are various etiologies of EM that can be classified into general categories: reactive, clonal, and idiopathic. We present a case of EM caused by chronic eosinophilic leukemia, a rare myeloproliferative neoplasm that frequently presents with sustained peripheral eosinophilia. This case displays several serious complications of EM, including recurrent ventricular tachycardia storm, cardiogenic shock, and mural thrombus formation despite anticoagulation. Diagnosis of EM can be difficult as formal diagnosis requires an endomyocardial biopsy. Once EM is suspected, identifying the underlying etiology of eosinophilia is critical for timely implementation of disease-specific therapy.

摘要

嗜酸性粒细胞性心肌炎(EM)是持续性嗜酸性粒细胞增多症罕见但可能致命的并发症,其特征是嗜酸性粒细胞浸润心肌组织。EM有多种病因,可分为以下几类:反应性、克隆性和特发性。我们报告一例由慢性嗜酸性粒细胞白血病引起的EM病例,慢性嗜酸性粒细胞白血病是一种罕见的骨髓增殖性肿瘤,常表现为持续性外周嗜酸性粒细胞增多。该病例显示了EM的几种严重并发症,包括反复室性心动过速风暴、心源性休克和尽管进行了抗凝治疗仍出现壁血栓形成。EM的诊断可能很困难,因为正式诊断需要进行心内膜心肌活检。一旦怀疑患有EM,确定嗜酸性粒细胞增多的潜在病因对于及时实施针对疾病的治疗至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/de7f/11034619/3b0fa568ab17/cureus-0016-00000056779-i01.jpg

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