[Churg-Strauss syndrome--cardiac problem in lung disease department]

Eosinophilia and pleural effusion may suggest pulmonary eosinophilia. We present a case of 42 years old woman with hypereosinophilia history since 5 months and no evidence of parasitic infections. She had no history of heart disease. Laboratory tests revealed eosinophilia (13.0 x 10(9)/l) and elevated serum IgE (2050 IU/ml), ANCA was not detected. ECP was not elevated. Pleural effusion contained 37% of eosinophils. An ECG revealed low voltage of QRS in all leads and Q waves in leads Vi-V-3. An echocardiography showed enlargement of left auricle and left ventricle with ejection fraction = 35%. The only pulmonary manifestation in this case was eosinophilic pleural effusions associated with congestive heart failure. A women was treated with prednisone 1 mg/kg/d and cyclophosphamide 2 mg/kg/d with clinical improvement and normalisation of eosinophil number in peripheral blood. But echocardiographic picture of the heart was nor better during 2 months of observation.