Usefulness of Cardiac Magnetic Resonance in the Diagnosis of Löffler Endocarditis Secondary to Eosinophilic Granulomatosis with Polyangiitis

Intern Med. 2019 Jan 15;58(2):239-242. doi: 10.2169/internalmedicine.1303-18. Epub 2018 Aug 24.

Abstract

A 40-year-old man who was diagnosed with bronchial asthma and eosinophilia was transferred to our hospital due to a worsening respiratory status. He was diagnosed with eosinophilic granulomatosis with polyangiitis (EGPA), and eosinophilic pneumoniae. Cardiac magnetic resonance (CMR) imaging indicated Löffler endocarditis. Treatment was initiated using intravenous methylprednisolone, cyclophosphamide, and heparin as anticoagulation therapy. Three months later, CMR showed the improvement of the LV myocardium. In this case, the early diagnosis of Löffler endocarditis by CMR could prevent systemic embolism and CMR was useful for assessing the curative effects of steroid and immunosuppressant therapy.

Keywords: Löffler endocarditis; cardiac magnetic resonance; eosinophilic granulomatosis with polyangiitis.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Anti-Inflammatory Agents / therapeutic use
  • Anticoagulants / therapeutic use
  • Asthma / complications
  • Cyclophosphamide / therapeutic use
  • Endocarditis / diagnostic imaging*
  • Endocarditis / etiology*
  • Eosinophilia / complications*
  • Granulomatosis with Polyangiitis / complications*
  • Granulomatosis with Polyangiitis / drug therapy
  • Heart / diagnostic imaging
  • Heparin / therapeutic use
  • Humans
  • Magnetic Resonance Imaging*
  • Male
  • Methylprednisolone / therapeutic use

Substances

  • Anti-Inflammatory Agents
  • Anticoagulants
  • Cyclophosphamide
  • Heparin
  • Methylprednisolone