Case Report

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

10.1501/Tıpfak_000000999

  • Hüseyin Göksülük
  • Demet Menekșe Gerede
  • İrem Müge Akbulut
  • Mustafa Fırat Coșkun
  • Cebrail Yarlıoğlueș
  • İrem Dinçer

Received Date: 30.10.2017 Accepted Date: 08.11.2017 J Ankara Univ Fac Med 2018;71(1):65-68

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, wall motion 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.

Keywords: Hypereosinophilic syndrome, eosinophilia, heart failure, thromboembolism.