Systemic thrombo-embolic events in a middle-aged male with Loeffler endocarditis without peripheral eosinophilia—a case report
Abstract Background Loeffler-endocarditis (LE) is considered a chronic restrictive cardiomyopathy and manifestation of eosinophilic myocarditis characterized by eosinophilic infiltration. LE is a rare underdiagnosed disease and associated with high morbidity and mortality. Case presentation We repor...
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| Format: | Article |
| Language: | English |
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BMC
2022-12-01
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| Series: | BMC Cardiovascular Disorders |
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| Online Access: | https://doi.org/10.1186/s12872-022-02911-3 |
| _version_ | 1798005286053609472 |
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| author | Mintje Bohné Sebastian Bohnen Hans-Christian Voigt Hendrik van der Schalk Da-Un Chung Stephan Willems Karin Klingel Dietmar Kivelitz Edda Bahlmann |
| author_facet | Mintje Bohné Sebastian Bohnen Hans-Christian Voigt Hendrik van der Schalk Da-Un Chung Stephan Willems Karin Klingel Dietmar Kivelitz Edda Bahlmann |
| author_sort | Mintje Bohné |
| collection | DOAJ |
| description | Abstract Background Loeffler-endocarditis (LE) is considered a chronic restrictive cardiomyopathy and manifestation of eosinophilic myocarditis characterized by eosinophilic infiltration. LE is a rare underdiagnosed disease and associated with high morbidity and mortality. Case presentation We report a case of a 46-year-old man suffering from LE associated with thromboembolic events without peripheral eosinophilia. The patient presented with typical clinical signs of acute onset of limb ischaemia, predominantly on the right limb, indicating immediate iliacal thrombectomy and due to a severe compartment syndrome additional fasciotomy. Total occlusion also of left popliteal artery suggesting an impaired chronic and aggravated impaired perfusion indicated also urgent left sided revascularization. Subsequent echocardiography revealed severe left ventricular dysfunction with a striking amount of spontaneous echo-contrast, noticeable in the left ventricular cavity. Furthermore the initial CT scan demonstrated asymptomatic left kidney- and brain infarctions. Diagnostic workup including endomyocardial biopsy (EMB) of the left ventricle, uncovered an underlying LE without peripheral eosinophilia. Conclusions This case demonstrates and highlights the findings, treatment and outcome of a patient with LE and associated thrombo-embolic events without peripheral eosinophilia and emphazises the importance of awareness for LE in patients presenting with an acute cardiac decompensation and thrombo-embolic events. EMB should be performed early in unstable patients unsuitable for cardiovascular magnetic resonance imaging. |
| first_indexed | 2024-04-11T12:37:59Z |
| format | Article |
| id | doaj.art-a15f4a5cd0ee4ec4bd1ce41ef4b48f55 |
| institution | Directory Open Access Journal |
| issn | 1471-2261 |
| language | English |
| last_indexed | 2024-04-11T12:37:59Z |
| publishDate | 2022-12-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Cardiovascular Disorders |
| spelling | doaj.art-a15f4a5cd0ee4ec4bd1ce41ef4b48f552022-12-22T04:23:35ZengBMCBMC Cardiovascular Disorders1471-22612022-12-012211710.1186/s12872-022-02911-3Systemic thrombo-embolic events in a middle-aged male with Loeffler endocarditis without peripheral eosinophilia—a case reportMintje Bohné0Sebastian Bohnen1Hans-Christian Voigt2Hendrik van der Schalk3Da-Un Chung4Stephan Willems5Karin Klingel6Dietmar Kivelitz7Edda Bahlmann8Department of Cardiology, Asklepios Clinic St. GeorgDepartment of Cardiology, Asklepios Clinic St. GeorgDepartment of Vascular and Endovascular Surgery, Asklepios Clinic St. GeorgDepartment of Cardiology, Asklepios Clinic St. GeorgDepartment of Cardiology, Asklepios Clinic St. GeorgDepartment of Cardiology, Asklepios Clinic St. GeorgCardiopathology, Institute for Pathology, University Hospital TübingenDepartment of Radiology, Asklepios Clinic St. GeorgDepartment of Cardiology, Asklepios Clinic St. GeorgAbstract Background Loeffler-endocarditis (LE) is considered a chronic restrictive cardiomyopathy and manifestation of eosinophilic myocarditis characterized by eosinophilic infiltration. LE is a rare underdiagnosed disease and associated with high morbidity and mortality. Case presentation We report a case of a 46-year-old man suffering from LE associated with thromboembolic events without peripheral eosinophilia. The patient presented with typical clinical signs of acute onset of limb ischaemia, predominantly on the right limb, indicating immediate iliacal thrombectomy and due to a severe compartment syndrome additional fasciotomy. Total occlusion also of left popliteal artery suggesting an impaired chronic and aggravated impaired perfusion indicated also urgent left sided revascularization. Subsequent echocardiography revealed severe left ventricular dysfunction with a striking amount of spontaneous echo-contrast, noticeable in the left ventricular cavity. Furthermore the initial CT scan demonstrated asymptomatic left kidney- and brain infarctions. Diagnostic workup including endomyocardial biopsy (EMB) of the left ventricle, uncovered an underlying LE without peripheral eosinophilia. Conclusions This case demonstrates and highlights the findings, treatment and outcome of a patient with LE and associated thrombo-embolic events without peripheral eosinophilia and emphazises the importance of awareness for LE in patients presenting with an acute cardiac decompensation and thrombo-embolic events. EMB should be performed early in unstable patients unsuitable for cardiovascular magnetic resonance imaging.https://doi.org/10.1186/s12872-022-02911-3Loeffler EndocarditisThromboembolic eventsCase report |
| spellingShingle | Mintje Bohné Sebastian Bohnen Hans-Christian Voigt Hendrik van der Schalk Da-Un Chung Stephan Willems Karin Klingel Dietmar Kivelitz Edda Bahlmann Systemic thrombo-embolic events in a middle-aged male with Loeffler endocarditis without peripheral eosinophilia—a case report BMC Cardiovascular Disorders Loeffler Endocarditis Thromboembolic events Case report |
| title | Systemic thrombo-embolic events in a middle-aged male with Loeffler endocarditis without peripheral eosinophilia—a case report |
| title_full | Systemic thrombo-embolic events in a middle-aged male with Loeffler endocarditis without peripheral eosinophilia—a case report |
| title_fullStr | Systemic thrombo-embolic events in a middle-aged male with Loeffler endocarditis without peripheral eosinophilia—a case report |
| title_full_unstemmed | Systemic thrombo-embolic events in a middle-aged male with Loeffler endocarditis without peripheral eosinophilia—a case report |
| title_short | Systemic thrombo-embolic events in a middle-aged male with Loeffler endocarditis without peripheral eosinophilia—a case report |
| title_sort | systemic thrombo embolic events in a middle aged male with loeffler endocarditis without peripheral eosinophilia a case report |
| topic | Loeffler Endocarditis Thromboembolic events Case report |
| url | https://doi.org/10.1186/s12872-022-02911-3 |
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