Leffler's parietal fibroplastic endocarditis

Abstract

Leffler's endocarditis is a rare and little-known disease to a wide range of practitioners. It was first described in 1936 by Leffler and named fibroplastic parietal endocarditis with eosinophilia. It is characterized by heart damage, high blood eosinophilia and leukocytosis. At the same time, symptoms associated with developing eosinophilic vasculitis of various internal organs (lungs, kidneys, spleen, liver, etc.) are observed. With this heart lesion, significant endocardial fibrosis appears, primarily parietal, there is an increase in collagen fibers, infiltration by lymphocytes and eosinophils of the endocardium and myocardium. A large number of parietal blood clots are formed in the cavities of the heart. A sharp thickening of the parietal endocardium and massive thrombotic layers on its surface create an unyielding framework from the inside, which leads to the development of severe rapidly progressive heart failure. The complexity of the diagnosis of the disease is due to the extreme polymorphism of the clinical picture. Leffler's endocarditis should be assumed with a combination of progressive heart failure (if its size is almost normal) with pronounced eosinophilia of the blood.