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Akut Kalp Yetmezliği ve Mezenterik Tromboembolizm ile Ortaya Çıkan İdiyopatik Hipereozinofilik Sendrom: Literatürün Gözden Geçirilmesi

Yıl 2018, Cilt: 71 Sayı: 1, 65 - 68, 16.10.2018

Hüseyin Göksülük

Öz

İdiyopatik hipereozinofilik sendromun kardiyak tutulumuna bağlı gelișen akut kalp yetmezliği kötü prognoza ve yüksek mortalite hızına sahiptir. Burada, akut kalp yetmezliği ve mezenterik tromboembolizme sebep olan hipereozinofilik sendromlu 52 yașında bir erkek hastayı sunuyoruz. Akut kalp yetmezliğinin ayırıcı tanısında
ST yükselmeli olmayan myokart infarktüsü (troponin yüksekliği) düșünüldü. Ancak akut koroner sendrom tanısı koroner anjiyografi ile dıșlandı. Laboratuvar bulgularında hipereozinofili vardı. Kardiyak manyetik rezonans görüntülemede (MR) difüz sol ventriküler genișleme, duvar hareket bozukluğu ve subendokardiyal fibrozis olmaksızın apikal trombüs izlendi. Hasta kalp yetmezliği kılavuzuna göre tedavi edildi ve hastanın kliniği düzeldi. Kortikosteroid tedavisi ile eozinofil sayısı ve CRP seviyesi normale sınırlara geriledi. Buna rağmen masif mezenterik tromboembolizm nedeniyle hastanın klinik durumu kötülești ve kardiyojenik șok ve sepsis nedeniyle hasta kaybedildi. Hastalığın patogenezinde, eozinofil kaynaklı granüller, kardiyak hasardan ve akut kalp yetmezliğinden endomyokardiyal fibrozise kadar değișen klinik çeșitlilikten sorumlu
olabilir. Erken tanı ve tedavi ile morbidite ve mortalite önlenebilir.

Anahtar Kelimeler

Hipereozinofilik sendrom eozinofili kalp yetmezliği tromboembolizm.

Etik Beyan

-

Destekleyen Kurum

-

Proje Numarası

-

Teşekkür

-

Kaynakça

  • 1. Simon HU, Rothenberg ME, Bochner BS et al. Refining the definition of hypereosinophilic syndrome. J Allergy Clin Immunol. 2010;126:45-49.
  • 2. Mankad R, Bonnichsen C, Mankad S. Hypereosinophilic syndrome: cardiac diagnosis and management. Heart 2016;102(2):100-6.
  • 3. Ommen SR, Seward JB, Tajik AJ. Clinical and echocardiographic features of hypereosinophilic syndromes. Am J Cardiol 2000;86(1):110-3.
  • 4. Kleinfeldt T, Nienaber CA, Kische S et al. Cardiac manifestation of the hypereosinophilic syndrome: newinsights. Clin Res Cardiol 2010;99(7):419-27.
  • 5. Gotlib J. World Health Organization-defined eosinophilic disorders: 2014 update on diagnosis, risk stratification, and management. Am J Hematol 2014 Mar. 89(3):325-37.
  • 6. Chusid MJ, Dale DC, West BC et al. The hypereosinophilic syndrome: analysis of fourteen cases with review of the literature. Medicine (Baltimore). 1975;54(1): 1-27.
  • 7. Weller PF, Bubley GJ. The idiopathic hypereosinophilic syndrome. Blood. 1994;83(10):2759-79.
  • 8. Cincin AA, Ozben B, Tanrikulu MA et al. Large apical thrombus in a patient with persistent heart failure and hypereosinophilia: Löffler endocarditis. J Gen Intern Med 2008; 23:1713-8.
  • 9. Fuzellier JF, Chapoutot L, Torossian PF et al. Mitral valve replacement in idiopathic eosinophilic endocarditis without peripheral eosinophilia. J Card Surg 2005; 20(5):472-4.
  • 10. Ogbogu PU, Rosing DR, Horne MK. Cardiovascular manifestations of hypereosinophilic syndromes. Immunol Allergy Clin North Am 2007;27(3):457-75.
  • 11. Gottdiener JS, Maron BJ, Schooley RT et al. Two-dimensional echocardiographic assessment of the idiopathic hypereosinophilic syndrome. Anatomic basis of mitral regurgitation and peripheral embolization. Circulation 1983;67(3):572-8.
  • 12. Yu IT, Chiang H, Wang JH. Hypereosinophilic syndrome with Löffler's endomyocarditis: report of an autopsy case. Taiwan Yi Xue Hui Za Zhi. 1989;88(7):740-3.
  • 13. Tanino M, Kitamura K, Ohta G et al. Hypereosinophilic syndrome with extensive myocardial involvement and mitral valve thrombus instead of mural thrombi. Acta Pathol Jpn. 1983;33(6):1233-42.
  • 14. Christen R, Morant R, Schneider J et al. Progressive dilated cardiomyopathy in a patient with longstanding and complete prednisone-induced hematological remission of idiopathic hypereosinophilic syndrome. Klin Wochenschr. 1989;67(6):358-65.
  • 15. Rasche RFH, Kelsch RD, Weaver DK. Loffler's endocarditis in childhood. British Heart Journal, I973, 35, 774-6.
  • 16. Niemeijer ND, van Daele PL, Caliskan K et al. Löffler endocarditis: a rare cause of acute cardiac failure. J Cardiothorac Surg. 2012;7:109.
  • 17. Syed IS, Martinez MW, Feng DL et al. Cardiac magnetic resonance imaging of eosinophilic endomyocardial disease. Int J Cardiol. 2008; 126(3):e50–2.
  • 18. Holzmann M, Nicko A, Kuhl U et al. Complication rate of right ventricular endomyocardial biopsy via the femoral approach: a retrospective and prospective study analyzing 3048 diagnostic procedures over an 11-year period. Circulation 2008; 118(17):1722-8

Idiopathic Hypereosinophilic Syndrome Presenting With Acute Heart Failure and Mesenteric Thromboembolism: Review of the Literature*

Yıl 2018, Cilt: 71 Sayı: 1, 65 - 68, 16.10.2018

Hüseyin Göksülük

Öz

Acute heart failure due to cardiac involvement of idiopathic hypereosinophilic syndrome has poor prognosis and high mortality rate. We present a 52 year old male patient with hypereosinophilic syndrome resulting in acute heart failure and mesenteric thromboembolism. Non ST elevation myocardial infarction (high troponin
levels) was considered in the differential diagnosis of acute heart failure. However acute coronary syndrome was excluded with diagnostic coronary angiography. The laboratory results showed hypereosinophilia on the blood count. Cardiac magnetic resonance imaging (CMR) showed diffuse left ventricular dilatation, wallmotion abnormalities and left ventricular apical thrombus without subendocardial fibrosis. He was treated according to heart failure guidelines and the patient status improved clinically. With the corticosteroid treatment, eosinophil count, C-reactive protein levels returned to normal range. Nevertheless, his clinical condition deteriorated due to massive mesenteric thromboembolism and died after cardiogenic shock and sepsis. In the pathogenesis of the disease, eosinophil derived granüls may be responsible for the cardiac damage and clinical variability that was ranging from cardiogenic shock to endomyocardial fibrosis. Early diagnosis and treatment can prevent morbidity and mortality.

Anahtar Kelimeler

Hypereosinophilic syndrome eosinophilia heart failure thromboembolism

Etik Beyan

-

Destekleyen Kurum

-

Proje Numarası

-

Teşekkür

-

Kaynakça

  • 1. Simon HU, Rothenberg ME, Bochner BS et al. Refining the definition of hypereosinophilic syndrome. J Allergy Clin Immunol. 2010;126:45-49.
  • 2. Mankad R, Bonnichsen C, Mankad S. Hypereosinophilic syndrome: cardiac diagnosis and management. Heart 2016;102(2):100-6.
  • 3. Ommen SR, Seward JB, Tajik AJ. Clinical and echocardiographic features of hypereosinophilic syndromes. Am J Cardiol 2000;86(1):110-3.
  • 4. Kleinfeldt T, Nienaber CA, Kische S et al. Cardiac manifestation of the hypereosinophilic syndrome: newinsights. Clin Res Cardiol 2010;99(7):419-27.
  • 5. Gotlib J. World Health Organization-defined eosinophilic disorders: 2014 update on diagnosis, risk stratification, and management. Am J Hematol 2014 Mar. 89(3):325-37.
  • 6. Chusid MJ, Dale DC, West BC et al. The hypereosinophilic syndrome: analysis of fourteen cases with review of the literature. Medicine (Baltimore). 1975;54(1): 1-27.
  • 7. Weller PF, Bubley GJ. The idiopathic hypereosinophilic syndrome. Blood. 1994;83(10):2759-79.
  • 8. Cincin AA, Ozben B, Tanrikulu MA et al. Large apical thrombus in a patient with persistent heart failure and hypereosinophilia: Löffler endocarditis. J Gen Intern Med 2008; 23:1713-8.
  • 9. Fuzellier JF, Chapoutot L, Torossian PF et al. Mitral valve replacement in idiopathic eosinophilic endocarditis without peripheral eosinophilia. J Card Surg 2005; 20(5):472-4.
  • 10. Ogbogu PU, Rosing DR, Horne MK. Cardiovascular manifestations of hypereosinophilic syndromes. Immunol Allergy Clin North Am 2007;27(3):457-75.
  • 11. Gottdiener JS, Maron BJ, Schooley RT et al. Two-dimensional echocardiographic assessment of the idiopathic hypereosinophilic syndrome. Anatomic basis of mitral regurgitation and peripheral embolization. Circulation 1983;67(3):572-8.
  • 12. Yu IT, Chiang H, Wang JH. Hypereosinophilic syndrome with Löffler's endomyocarditis: report of an autopsy case. Taiwan Yi Xue Hui Za Zhi. 1989;88(7):740-3.
  • 13. Tanino M, Kitamura K, Ohta G et al. Hypereosinophilic syndrome with extensive myocardial involvement and mitral valve thrombus instead of mural thrombi. Acta Pathol Jpn. 1983;33(6):1233-42.
  • 14. Christen R, Morant R, Schneider J et al. Progressive dilated cardiomyopathy in a patient with longstanding and complete prednisone-induced hematological remission of idiopathic hypereosinophilic syndrome. Klin Wochenschr. 1989;67(6):358-65.
  • 15. Rasche RFH, Kelsch RD, Weaver DK. Loffler's endocarditis in childhood. British Heart Journal, I973, 35, 774-6.
  • 16. Niemeijer ND, van Daele PL, Caliskan K et al. Löffler endocarditis: a rare cause of acute cardiac failure. J Cardiothorac Surg. 2012;7:109.
  • 17. Syed IS, Martinez MW, Feng DL et al. Cardiac magnetic resonance imaging of eosinophilic endomyocardial disease. Int J Cardiol. 2008; 126(3):e50–2.
  • 18. Holzmann M, Nicko A, Kuhl U et al. Complication rate of right ventricular endomyocardial biopsy via the femoral approach: a retrospective and prospective study analyzing 3048 diagnostic procedures over an 11-year period. Circulation 2008; 118(17):1722-8
Toplam 18 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Kardiyoloji
Bölüm Makaleler
Yazarlar

Hüseyin Göksülük

Proje Numarası -
Yayımlanma Tarihi 16 Ekim 2018
Yayımlandığı Sayı Yıl 2018 Cilt: 71 Sayı: 1

Kaynak Göster

APA Göksülük, H. (2018). Idiopathic Hypereosinophilic Syndrome Presenting With Acute Heart Failure and Mesenteric Thromboembolism: Review of the Literature*. Ankara Üniversitesi Tıp Fakültesi Mecmuası, 71(1), 65-68.
AMA Göksülük H. Idiopathic Hypereosinophilic Syndrome Presenting With Acute Heart Failure and Mesenteric Thromboembolism: Review of the Literature*. Ankara Üniversitesi Tıp Fakültesi Mecmuası. Ekim 2018;71(1):65-68.
Chicago Göksülük, Hüseyin. “Idiopathic Hypereosinophilic Syndrome Presenting With Acute Heart Failure and Mesenteric Thromboembolism: Review of the Literature*”. Ankara Üniversitesi Tıp Fakültesi Mecmuası 71, sy. 1 (Ekim 2018): 65-68.
EndNote Göksülük H (01 Ekim 2018) Idiopathic Hypereosinophilic Syndrome Presenting With Acute Heart Failure and Mesenteric Thromboembolism: Review of the Literature*. Ankara Üniversitesi Tıp Fakültesi Mecmuası 71 1 65–68.
IEEE H. Göksülük, “Idiopathic Hypereosinophilic Syndrome Presenting With Acute Heart Failure and Mesenteric Thromboembolism: Review of the Literature*”, Ankara Üniversitesi Tıp Fakültesi Mecmuası, c. 71, sy. 1, ss. 65–68, 2018.
ISNAD Göksülük, Hüseyin. “Idiopathic Hypereosinophilic Syndrome Presenting With Acute Heart Failure and Mesenteric Thromboembolism: Review of the Literature*”. Ankara Üniversitesi Tıp Fakültesi Mecmuası 71/1 (Ekim 2018), 65-68.
JAMA Göksülük H. Idiopathic Hypereosinophilic Syndrome Presenting With Acute Heart Failure and Mesenteric Thromboembolism: Review of the Literature*. Ankara Üniversitesi Tıp Fakültesi Mecmuası. 2018;71:65–68.
MLA Göksülük, Hüseyin. “Idiopathic Hypereosinophilic Syndrome Presenting With Acute Heart Failure and Mesenteric Thromboembolism: Review of the Literature*”. Ankara Üniversitesi Tıp Fakültesi Mecmuası, c. 71, sy. 1, 2018, ss. 65-68.
Vancouver Göksülük H. Idiopathic Hypereosinophilic Syndrome Presenting With Acute Heart Failure and Mesenteric Thromboembolism: Review of the Literature*. Ankara Üniversitesi Tıp Fakültesi Mecmuası. 2018;71(1):65-8.
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