침윤성 심근병증 형태를 동반한 호산구증가증후군 1예
A Case of Left Ventricular Infiltrative Cardiomyopathy in Hypereosinophilic Syndrome
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Idiopathic hypereosinophilic syndrome (HES) is characterized by peripheral blood eosinophilia and multiorgan dysfunction in the absence of known causes of hypereosinophilia. HES shows tissue infiltration in many organs including heart, lung, liver and gastrointestinal tract. A 38- year-old man presented to the outpatient clinic complaining of chest discomfort for 2 days. Routine blood tests showed an increased eosinophil count (2,796/㎣). Transthoracic echocardiography and chest CT revealed generalized thickening of the left ventricle. Bronchoalveolar larvageshowed marked increase of eosinophil up to 72%. The patient was diagnosed with HES, which involved heart and lung. He was treated with oral glucocorticoid for 7 days. His symptoms were improved dramatically and myocardial deposits disappeared. Cardiac and pulmonary manifestations are common in HES and these were present in this case. We herein report a case of HES presenting cardiac involvement as infiltrative pattern at the left ventricle and pulmonary involvement. As in our case, early diagnosis often leads to more appropriate management and better prognosis.
Abstract
Idiopathic hypereosinophilic syndrome (HES) is characterized by peripheral blood eosinophilia and multiorgan dysfunction in the absence of known causes of hypereosinophilia. HES shows tissue infiltration in many organs including heart, lung, liver and gastrointestinal tract. A 38- year-old man presented to the outpatient clinic complaining of chest discomfort for 2 days. Routine blood tests showed an increased eosinophil count (2,796/㎣). Transthoracic echocardiography and chest CT revealed generalized thickening of the left ventricle. Bronchoalveolar larvageshowed marked increase of eosinophil up to 72%. The patient was diagnosed with HES, which involved heart and lung. He was treated with oral glucocorticoid for 7 days. His symptoms were improved dramatically and myocardial deposits disappeared. Cardiac and pulmonary manifestations are common in HES and these were present in this case. We herein report a case of HES presenting cardiac involvement as infiltrative pattern at the left ventricle and pulmonary involvement. As in our case, early diagnosis often leads to more appropriate management and better prognosis.
참고문헌 (13)
- Irani C, "Evaluation of eosinophilia, Patterson’s allergic diseases. 6th ed", pp.683~701 (2002), Lippincott Co
- Chusid MJ, "The hypereosinophilic syndrome: analysis of fourteen cases with review of the literature", Medicine, 54, pp.1~27 (1975)
- Fauci AS, "NIH conference. The idiopathic hypereosinophilic syndrome. in: Clinical, pathophysiologic, and therapeutic considerations", Ann Intern Med, 97, pp.78~92 (1982)
- Weller PF, "The idiopathic hypereosinophilic syndrome", Blood, 83, pp.2759~2779 (1994)
- 노혜진, "좌심실혈전으로 나타난 과호산구증후군 1예", 천식 및 알레르기, 27(3), pp.190~194 (2007), 대한천식알레르기학회
- 이주희, "중증 심막 삼출로 나타난 과호산구 증후군 1례", Korean Circulation Journal, 32(1), pp.76~79 (2002), 대한심장학회
- 박용호, "급성 호산구성 심근염으로 나타난 과호산구 증후군 1예", 대한내과학회지, 66(3), pp.284~287 (2004), 대한내과학회
- Tefferi A, "Eosinophilia: secondary, clonal and idiopathic", Br J Haematol, 133, pp.468~492 (2006)
- Peros-Golubicić T, "Hypereosinophilic syndrome: diagnosis and treatment", Curr Opin Pulm Med, 13, pp.422~427 (2007)
- Cogan E, "Brief report: clonal proliferation of type 2 helper T cells in a man with the hypereosinophilic syndrome", N Engl J Med, 330, pp.535~538 (1994)
- Borer JS, "Echocardiographic observations in patients with systemic infiltrative disease involving the heart", Am J Cardiol, 39, pp.184~188 (1977)
- Benezet-Mazuecos J, "Images in cardiovascular medicine. Early differential resolution of right and left ventricular obliteration in L?ffler endocarditis after chemotherapy and anticoagulation", Circulation, 114, pp.e635~e637 (2006)
- Wechsler ME, "Pulmonary eosinophilic syndromes", Immunol Allergy Clin North Am, 27, pp.477~492 (2007)