Eosinophilic Myocarditis due to Toxocariasis: Not a Rare Cause.

Shunichi Shibazaki,Tadamasa Wakabayashi,Norihide Taniuchi,Makoto Araki,Taku Imai,Takashi Endo,Yoshiaki Gu,Kouji Asano,Shunsuke Eguchi

doi:10.1155/2016/2586292

Abstract

Myocarditis is a clinically important disease because of the high mortality. From the perspective of treatment strategy, eosinophilic myocarditis should be distinguished from other types of myocarditis. Toxocariasis, caused by Toxocara canis or Toxocara cati, is known as a cause of eosinophilic myocarditis but is considered rare. As it is an unpopular disease, eosinophilic myocarditis due to toxocariasis may be underdiagnosed. We experienced two cases of eosinophilic myocarditis due to toxocariasis from different geographical areas in quick succession between 2013 and 2014. Case 1 is 32-year-old man. Case 2 is 66-year-old woman. In both cases, diagnosis was done by endomyocardial biopsy and IgG-ELISA against Toxocara excretory-secretory antigen. Only a corticosteroid was used in Case 1, whereas a corticosteroid and albendazole were used in Case 2 as induction therapy. Both patients recovered. Albendazole was also used in Case 1 to prevent recurrence after induction therapy. Eosinophilic myocarditis by toxocariasis may in actuality not be a rare disease, and corticosteroid is an effective drug as induction therapy even before use of albendazole.

Highlights

Myocarditis is a serious clinical situation that is considered rare as it is found in only 0.1% of pathological autopsies [1]
We examined a commercial multiple-dot ELISA kit (SRL, Tokyo, Japan) as a screening test; anti-IgG to T. canis was detected in his serum
Toxocariasis is often overlooked as a cause of eosinophilic myocarditis; the frequency of reports on toxocariasis causing this disease may be inaccurate

Summary

Introduction

Myocarditis is a serious clinical situation that is considered rare as it is found in only 0.1% of pathological autopsies [1]. It has a high mortality rate (38–54%) [2]. The frequency of other causes of eosinophilic myocarditis is not well understood, and there are only 14 reports of eosinophilic myocarditis due to toxocariasis, caused by Toxocara canis (T. canis) or Toxocara cati (T. cati) [4]. The reports presented here indicate that it may be helpful to use corticosteroids as induction therapy for eosinophilic myocarditis due to toxocariasis

Case Report

Findings

Discussion

Conclusions