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Cellular fraction analysis of pericardial effusion helps the diagnosis of eosinophilic myocarditis

Published online by Cambridge University Press:  20 November 2018

Etsuko Tsuda ,
Yuka Toyoshima ,
Osamu Yamada ,
Masanori Tsukada ,
Jun Negishi ,
Heima Sakaguchi ,
Yoshihiko Ikeda  and
Hatsue Ishibashi-Udea
Etsuko Tsuda*
Affiliation:
Department of Pediatric Cardiology, National Cerebral and Cardiovascular Center, Osaka, Japan
Yuka Toyoshima
Affiliation:
Department of Pediatric Cardiology, National Cerebral and Cardiovascular Center, Osaka, Japan
Osamu Yamada
Affiliation:
Department of Pathology, National Cerebral and Cardiovascular Center, Osaka, Japan
Masanori Tsukada
Affiliation:
Department of Pediatric Cardiology, National Cerebral and Cardiovascular Center, Osaka, Japan
Jun Negishi
Affiliation:
Department of Pediatric Cardiology, National Cerebral and Cardiovascular Center, Osaka, Japan
Heima Sakaguchi
Affiliation:
Department of Pediatric Cardiology, National Cerebral and Cardiovascular Center, Osaka, Japan
Yoshihiko Ikeda
Affiliation:
Department of Pathology, National Cerebral and Cardiovascular Center, Osaka, Japan
Hatsue Ishibashi-Udea
Affiliation:
Department of Pathology, National Cerebral and Cardiovascular Center, Osaka, Japan
*
Author for correspondence: Etsuko Tsuda, MD, Department of Pediatric Cardiology, National Cerebral and Cardiovascular Center, 5-7-1 Fujishirodai, Suita-shi, Osaka 565-8565, Japan. Tel: 81-6-6833-5012; Fax: 81-6-6872-7486; E-mail: etsuda@ncvc.go.jp
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Abstract

Eosinophilic myocarditis is rare in children, and consequently, it is difficult to diagnose eosinophilic myocarditis rapidly. We report the clinical course of acute eosinophilic myocarditis with pericarditis in two adolescent boys and their associated electrocardiograms. The two patients, 13- and 14-year-old boys, developed cardiomegaly and chest pain with vomiting. On examination by two-dimensional echocardiography, thickening of the ventricular septum and a pericardial effusion were detected. The eosinophil count had increased by the pericardial effusion. Acute eosinophilic myocarditis often complicates a moderate to severe pericardial effusion owing to acute pericarditis. A cellular fraction analysis of the pericardial effusion is easy and useful for the diagnosis of eosinophilic myocarditis. Some serial changes in the electrocardiogram occur during each stage of acute eosinophilic myocarditis. They are induced by eosinophilic granules, which are capable of inducing tissue damage and dysfunction, and those changes in the electrocardiogram resemble the changes after an acute myocardial infarction. It is important to know the characteristics of eosinophilic myocarditis in order to prevent lethal complications.

Keywords

Pericardial effusioneosinophilic myocarditiseosinophilic pericarditisacute myocarditisendomyocardial biopsy
Type
Original Article
Information
Cardiology in the Young , Volume 29 , Issue 2 , February 2019 , pp. 140 - 145
Copyright
© Cambridge University Press 2018 

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Footnotes

Cite this article: Tsuda E, Toyoshima Y, Yamada O, Tsukada M, Negishiv J, Sakaguchi H, Ikeda Y, Ishibashi-Udea H. (2018). Cellular fraction analysis of pericardial effusion helps the diagnosis of eosinophilic myocarditis. Cardiology in the Young. page 140 of 145. doi: 10.1017/S1047951118001956

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