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Loeffler endocarditis in a pediatric patient.
Anastasia Keivanidou1, Andreas Giannopoulos, Theodotis Papageorgiou
1Pediatric Cardiology Clinic, 2nd Pediatric Department, Ahepa University Hospital, Aristotle University of Thessaloniki , Thessaloniki , Greece.
Pediatric Hematology and Oncology
|June 28, 2013
Summary
Loeffler endocarditis, a severe complication of hypereosinophilic syndrome, was successfully treated in a pediatric patient with imatinib. This tyrosine kinase inhibitor resolved eosinophilia and cardiac issues, even without a specific genetic marker.
Area of Science:
- Cardiology
- Hematology
- Pediatric Medicine
Background:
- Hypereosinophilic syndrome (HES) can lead to Loeffler endocarditis, a life-threatening cardiac condition.
- Corticosteroid therapy is a common treatment for HES, but some cases are refractory.
Observation:
- A 5-year-old girl with corticosteroid-refractory peripheral hypereosinophilia developed eosinophilia-related endocarditis.
- Echocardiography showed left ventricular free wall and mitral leaflet infiltration, causing moderate mitral regurgitation.
Findings:
- Genetic testing did not identify the FIP1L1-PDGRFA genotype.
- Treatment with imatinib, a tyrosine kinase inhibitor, resulted in complete resolution of eosinophilia within 4 weeks.
- Cardiac manifestations, including mitral regurgitation, completely resolved after imatinib therapy.
Implications:
- Imatinib is a viable treatment option for pediatric hypereosinophilic syndrome with cardiac involvement, even in the absence of the FIP1L1-PDGRFA genotype.
- This case underscores the importance of considering targeted therapies like imatinib for refractory HES.
- Early intervention with imatinib can prevent irreversible cardiac damage in pediatric HES patients.
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