末梢血中に好酸球増多を伴わず,拡張型心筋症様病態を呈した好酸球性心疾患の1例

Abstract

A 41-year-old woman was admitted to our hospital because of dyspnea. Physical examination revealed pulmonary congestion, hepatomegaly, and bilateral pretibial edema. She was diagnosed as having congestive heart failure. Blood examination revealed eosinophilia nor acute viral infection. Chest X-ray film showed increase in the cardiac silhouette and pulmonary cogestion in bilateral lung fields. Echocardiography revealed severe and generalized hypokinesis in left ventricular wall motion, and enlargement of the left atrial and ventricular dimensions, resembling dilated cardiomyopathy (DCM). En- domyocardial biopsy revealed severe hypertrophy of cardiomyocytes and their disarray. Moreover, eosinophils infiltrated into the fibrotic lesions around cardiomyocytes. As she was diagnosed as having eosinophilic heart disease, she was given predonisolone, 30mg daily. About 14 days after prednisolone therapy, dyspnea disappeared, and the cardiac silhouette decreased. In addition, echocardiography showed an improvement in cardiac function. We reported a rare case of eosinophilic heart disease whose systolic fuction decreased as DCM, and did not exhibit the eosinophilia.