ISSN 1016-5169 | E-ISSN 1308-4488
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Hypereosinophilic Syndrome Complicated by Eosinophilic Myocarditis: Embolic Stroke or Eosinophilic Stroke? A Case Report [Turk Kardiyol Dern Ars]
Turk Kardiyol Dern Ars. Ahead of Print: TKDA-46487 | DOI: 10.5543/tkda.2024.46487

Hypereosinophilic Syndrome Complicated by Eosinophilic Myocarditis: Embolic Stroke or Eosinophilic Stroke? A Case Report

Amirreza Sajjadieh Khajouei1, Marzieh Tajmirriahi2, Zahra Payandeh3, Mahsa Amirhajlou Mashhadi4, Nahid Shirani5, Seyedeh Mahnaz Mirbod6
1Department of Internal Medicine, School of Medicine, Al-Zahra Hospital, Isfahan University of Medical Science, Isfahan, Iran
2Hypertension Research Center Isfahan Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
3Student Research Committee, School of Medicine, Isfahan University of Medical Science, Isfahan, Iran
4Clinical Research Development Center, Islamic Azad University, Najafabad, Isfahan, Iran
5Heart Failure Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
6Department of Cardiology, Isfahan University of Medical Sciences, Isfahan, Iran

Hyper eosinophilic syndrome (HES) is traditionally described as chronic peripheral eosinophilia with involvement of various organs and systems such as heart and nervous system. In this report we describe cardiac involvement and border zone stroke in a patient with idiopathic HES. A 37-year-old woman presented with sudden right-sided weakness, Slurring of speech since 4 days before admission, and palpitation, retrosternal exertional chest discomfort, dry cough, and progressive shortness of breath for about 2 months. Preliminary studies indicated an increased number of white blood cells with eosinophilia. Further diagnostic investigation indicated the presence of apical thrombosis in both ventricles of the heart and moderate left ventricular systolic dysfunction. Magnetic resonance imaging(MRI) for evaluating the brain showed multifocal infarction of anterior and posterior border zones, as well as both cerebellar hemispheres, with a greater concentration on the left side. Consequently, the patient was diagnosed with idiopathic HES.Therefore the patient received corticosteroid, cyclophosphamide, anticoagulant, and medicines for heart failure and responded clinically and hematologically. Our case highlights the importance of multiple imaging modalities in the diagnostic process of eosinophilic endomyocarditis as well as the impact of timely medical treatment to prevent disease progression.

Keywords: Hyper eosinophilic syndrome, eosinophilic myocarditis, eosinophilic stroke

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Corresponding Author: Seyedeh Mahnaz Mirbod
Manuscript Language: English


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