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[Löffler endocarditis fibroplastica with simultaneous infectious endocarditis]

V Menz1, L Drude, U Schönian

  • 1Abteilung Innere Medizin-Kardiologie, Philipps-Universität Marburg.

Herz
|June 1, 1994
PubMed
Summary

This case study details an 8-year follow-up of hypereosinophilic syndrome and Löffler's endocarditis in a 45-year-old female. The patient presented with cardiac involvement, autoreactive myocarditis, and later infective endocarditis requiring valve replacement.

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Area of Science:

  • Cardiology
  • Immunology
  • Rheumatology

Background:

  • Presents an 8-year clinical and immunological follow-up of a 45-year-old female with hypereosinophilic syndrome.
  • Focuses on cardiac involvement, specifically Löffler's fibroplastic endocarditis, complicated by infective endocarditis during immunosuppressive therapy.

Observation:

  • Documented all three stages of Löffler's endocarditis through clinical and histological data, including eosinophilic myocarditis, arteritis, parietal thrombosis, and fibrosis.
  • Observed a lack of expected serological markers for Löffler's endocarditis but presence of autoreactive myocarditis with cytolytic, complement-fixing antimyolemmal antibodies.

Findings:

  • The patient underwent a complex treatment regimen including long-term prednisolone and azathioprine.
  • Developed infective endocarditis caused by Streptococcus sanguis, leading to severe mitral regurgitation and necessitating valve replacement.

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Implications:

  • Highlights the importance of comprehensive immunological assessment in hypereosinophilic syndrome with cardiac involvement.
  • Underscores the potential complications, such as infective endocarditis, in patients with Löffler's endocarditis undergoing immunosuppressive treatment.
  • Emphasizes the need for timely intervention, including valve replacement, for severe valvular complications.