TY - JOUR
AU1 - Yamamoto, Masayoshi
AU2 - Seo, Yoshihiro
AU3 - Ishizu, Tomoko
AU4 - Aonuma, Kazutaka
AB - A 76-year-old man hospitalized for acute heart failure had marked eosinophilia (white blood cells: 35.4 × 103/μL, with 83% eosinophils: 29.3 × 103/μL). He was diagnosed with idiopathic eosinophilia following detailed evaluation including bone marrow biopsy. A 2D transthoracic echocardiography showed obliteration of the right ventricular apex which is typical view for Löffler endocarditis with normal left ventricular ejection fraction of 56% (Panel A, arrow indicates “apical thrombus in the right ventricle”), and peak aortic valve velocity was 4.1 ms−1. Right ventricular endomyocardial biopsy showed infiltration with fibrin-containing thrombus and eosinophils (Panel B, scale bar: 100 μm), and Löffler endocarditis was diagnosed. Transoesophageal echocardiography showed severe aortic valve stenosis (aortic valve area by planimetry: 0.70 cm2) with fusion of three leaflets to create an unicuspid valve (Panel C; see Supplementary material online, Video S1). Oral prednisolone (30 mg/day) and hydroxyurea (500 mg/day) were started for Löffler endocarditis. After three months of treatment, he was scheduled for aortic valve replacement. However, eosinophilia was dramatically improved (white blood cells: 12.3 × 103/μL, with 29% eosinophils: 3.54 × 103/μL), and fusion of the aortic valve leaflets had disappeared (Panel D; see Supplementary material online, Video S2). Peak aortic valve velocity was reduced from 4.1 ms−1 to 2.0 ms−1. He did not undergo surgery and has had no recurrence of aortic valve stenosis and heart failure in the past 2 years. In patients with Löffler endocarditis, valves most commonly involved are atrioventricular valves with regurgitation and less commonly aortic valve. This is a quite unusual case of Löffler endocarditis and aortic valve stenosis improved by immunosuppressive treatment. View largeDownload slide View largeDownload slide Supplementary material is available at European Heart Journal online. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2018. For permissions, please email: journals.permissions@oup.com. This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (https://academic.oup.com/journals/pages/about_us/legal/notices)
TI - Reversible aortic valve stenosis with Löffler endocarditis
JF - European Heart Journal
DO - 10.1093/eurheartj/ehy094
DA - 2018-02-26
UR - https://www.deepdyve.com/lp/oxford-university-press/reversible-aortic-valve-stenosis-with-l-ffler-endocarditis-OeL0AEGTN7
SP - 2332
EP - 2332
VL - 39
IS - 24
DP - DeepDyve
ER -