A Case of Lymphocytic Myocarditis with Eosinophilic Degranulation Successfully Treated with Steroid Therapy
A 49-year-old woman was admitted with suspicion of acute myocarditis. On the next day after admission, her serum troponin I level continued to rise, indicating progression of myocardial damage. Moreover, her symptoms persisted, and left ventricular ejection fraction did not improve. Because of a pre...
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| Format: | Article |
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2020-01-01
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| Series: | Case Reports in Cardiology |
| Online Access: | http://dx.doi.org/10.1155/2020/8887726 |
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| author | Tomoko Inoue Fusako Sera Shunsuke Nishimura Kei Nakamoto Yasumasa Tsukamoto Isamu Mizote Tomohito Ohtani Shungo Hikoso Yoshihiko Ikeda Yumiko Hori Hatsue Ishibashi-Ueda Eiichi Morii Tetsuo Minamino Yasushi Sakata |
| author_facet | Tomoko Inoue Fusako Sera Shunsuke Nishimura Kei Nakamoto Yasumasa Tsukamoto Isamu Mizote Tomohito Ohtani Shungo Hikoso Yoshihiko Ikeda Yumiko Hori Hatsue Ishibashi-Ueda Eiichi Morii Tetsuo Minamino Yasushi Sakata |
| author_sort | Tomoko Inoue |
| collection | DOAJ |
| description | A 49-year-old woman was admitted with suspicion of acute myocarditis. On the next day after admission, her serum troponin I level continued to rise, indicating progression of myocardial damage. Moreover, her symptoms persisted, and left ventricular ejection fraction did not improve. Because of a predominant infiltration of lymphocytes in the myocardial specimens, lymphocytic myocarditis was diagnosed. However, a close observation of the specimens revealed eosinophil degranulation. Based on this finding, intravenous steroid therapy was initiated. High-dose methylprednisolone led to rapid and appreciable improvements in symptoms and left ventricular function within 12 hours after the first administration, which was followed by normalization of serum troponin I level. Steroid therapy was switched to oral administration and tapered carefully. There was no recurrence of left ventricular dysfunction or elevation of serum troponin I level. In eosinophilic myocarditis, eosinophil degranulation has been recognized as an important finding associated with progression of inflammation and myocardial damage. However, no attention has been paid to the presence and clinical implications of eosinophil degranulation in lymphocytic myocarditis. This case indicates that eosinophil degranulation in lymphocytic myocarditis may be an important finding associated with a high therapeutic response to steroid therapy. |
| format | Article |
| id | doaj-art-c9901383dda540388da23600ae8a4382 |
| institution | Kabale University |
| issn | 2090-6404 2090-6412 |
| language | English |
| publishDate | 2020-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Cardiology |
| spelling | doaj-art-c9901383dda540388da23600ae8a43822025-02-03T01:01:27ZengWileyCase Reports in Cardiology2090-64042090-64122020-01-01202010.1155/2020/88877268887726A Case of Lymphocytic Myocarditis with Eosinophilic Degranulation Successfully Treated with Steroid TherapyTomoko Inoue0Fusako Sera1Shunsuke Nishimura2Kei Nakamoto3Yasumasa Tsukamoto4Isamu Mizote5Tomohito Ohtani6Shungo Hikoso7Yoshihiko Ikeda8Yumiko Hori9Hatsue Ishibashi-Ueda10Eiichi Morii11Tetsuo Minamino12Yasushi Sakata13Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, Osaka, JapanDepartment of Cardiovascular Medicine, Osaka University Graduate School of Medicine, Osaka, JapanDepartment of Cardiovascular Medicine, Osaka University Graduate School of Medicine, Osaka, JapanDepartment of Cardiovascular Medicine, Osaka University Graduate School of Medicine, Osaka, JapanDepartment of Cardiovascular Medicine, Osaka University Graduate School of Medicine, Osaka, JapanDepartment of Cardiovascular Medicine, Osaka University Graduate School of Medicine, Osaka, JapanDepartment of Cardiovascular Medicine, Osaka University Graduate School of Medicine, Osaka, JapanDepartment of Cardiovascular Medicine, Osaka University Graduate School of Medicine, Osaka, JapanDepartment of Pathology, National Cardiovascular Center, Osaka, JapanDepartment of Pathology, Osaka University Graduate School of Medicine, Osaka, JapanDepartment of Pathology, National Cardiovascular Center, Osaka, JapanDepartment of Pathology, Osaka University Graduate School of Medicine, Osaka, JapanDepartment of Cardiorenal and Cerebrovascular Medicine, Faculty of Medicine, Kagawa University, Kagawa, JapanDepartment of Cardiovascular Medicine, Osaka University Graduate School of Medicine, Osaka, JapanA 49-year-old woman was admitted with suspicion of acute myocarditis. On the next day after admission, her serum troponin I level continued to rise, indicating progression of myocardial damage. Moreover, her symptoms persisted, and left ventricular ejection fraction did not improve. Because of a predominant infiltration of lymphocytes in the myocardial specimens, lymphocytic myocarditis was diagnosed. However, a close observation of the specimens revealed eosinophil degranulation. Based on this finding, intravenous steroid therapy was initiated. High-dose methylprednisolone led to rapid and appreciable improvements in symptoms and left ventricular function within 12 hours after the first administration, which was followed by normalization of serum troponin I level. Steroid therapy was switched to oral administration and tapered carefully. There was no recurrence of left ventricular dysfunction or elevation of serum troponin I level. In eosinophilic myocarditis, eosinophil degranulation has been recognized as an important finding associated with progression of inflammation and myocardial damage. However, no attention has been paid to the presence and clinical implications of eosinophil degranulation in lymphocytic myocarditis. This case indicates that eosinophil degranulation in lymphocytic myocarditis may be an important finding associated with a high therapeutic response to steroid therapy.http://dx.doi.org/10.1155/2020/8887726 |
| spellingShingle | Tomoko Inoue Fusako Sera Shunsuke Nishimura Kei Nakamoto Yasumasa Tsukamoto Isamu Mizote Tomohito Ohtani Shungo Hikoso Yoshihiko Ikeda Yumiko Hori Hatsue Ishibashi-Ueda Eiichi Morii Tetsuo Minamino Yasushi Sakata A Case of Lymphocytic Myocarditis with Eosinophilic Degranulation Successfully Treated with Steroid Therapy Case Reports in Cardiology |
| title | A Case of Lymphocytic Myocarditis with Eosinophilic Degranulation Successfully Treated with Steroid Therapy |
| title_full | A Case of Lymphocytic Myocarditis with Eosinophilic Degranulation Successfully Treated with Steroid Therapy |
| title_fullStr | A Case of Lymphocytic Myocarditis with Eosinophilic Degranulation Successfully Treated with Steroid Therapy |
| title_full_unstemmed | A Case of Lymphocytic Myocarditis with Eosinophilic Degranulation Successfully Treated with Steroid Therapy |
| title_short | A Case of Lymphocytic Myocarditis with Eosinophilic Degranulation Successfully Treated with Steroid Therapy |
| title_sort | case of lymphocytic myocarditis with eosinophilic degranulation successfully treated with steroid therapy |
| url | http://dx.doi.org/10.1155/2020/8887726 |
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