Abstract
Eosinophilic myocarditis is a rare and acute life threatening condition often associated with drug reactions, eosinophilic granulomatous polyangiitis (formerly Churg-Strauss syndrome), Loeffler endomyocardial disease, parasite infections, and idiopathic hypereosinophilic syndrome. We describe a case of eosinophilic granulomatous polyangiitis presenting as progressive pericardial effusion and cardiac tamponade.
Highlights
Eosinophilic myocarditis is a rare and acute life threatening condition often associated with drug reactions, eosinophilic granulomatous polyangiitis, Loeffler endomyocardial disease, parasite infections, and idiopathic hypereosinophilic syndrome
We describe a case of eosinophilic granulomatous polyangiitis presenting as progressive pericardial effusion and cardiac tamponade
Decision-making: Patient was diagnosed with eosinophilic granulomatosis with polyangiitis based on clinical criteria and histological evidence of serositis in the form of eosinophilic pericarditis with fibrinoid necrosis
Summary
Eosinophilic myocarditis is a rare and acute life threatening condition often associated with drug reactions, eosinophilic granulomatous polyangiitis (formerly Churg-Strauss syndrome), Loeffler endomyocardial disease, parasite infections, and idiopathic hypereosinophilic syndrome. We describe a case of eosinophilic granulomatous polyangiitis presenting as progressive pericardial effusion and cardiac tamponade. Case: A 23 year old male with history of occupational dust exposure to polycaprolactone and hydroxyapatite (working in a 3D printing laboratory), presented with progressive sinus congestion, exertional dyspnea, and wheezing. He was noted to have nasal polyps and pulmonary infiltrates. Serum troponin levels were found to be significantly elevated and transthoracic echocardiography confirmed large pericardial effusion with signs of tamponade physiology. Pericardial biopsy revealed fibrinoid necrosis with obliteration of the normal vessel layers and infiltration of degranulated eosinophils and neutrophils (Figure)
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