Fulminant eosinophilic myocarditis associated with visceral larva migrans caused by Toxocara canis infection

Kenki Enko; Takeshi Tada; Keiko O. Ohgo; Satoshi Nagase; Kazufumi Nakamura; Kei Ohta; Shingo Ichiba; Yoshihito Ujike; Yukifumi Nawa; Haruhiko Maruyama; Tohru Ohe; Kengo F. Kusano

doi:10.1253/circj.CJ-08-0334

Fulminant eosinophilic myocarditis associated with visceral larva migrans caused by Toxocara canis infection

Kenki Enko, Takeshi Tada, Keiko O. Ohgo, Satoshi Nagase, Kazufumi Nakamura, Kei Ohta, Shingo Ichiba, Yoshihito Ujike, Yukifumi Nawa, Haruhiko Maruyama, Tohru Ohe, Kengo F. Kusano

Research output: Contribution to journal › Article › peer-review

30 Citations (Scopus)

Abstract

A 19-year-old man was transferred to hospital because of myocarditis with cardiogenic shock. Echocardiography showed a left ventricular ejection fraction of 23.8% and an intermediate amount of pericardial effusion. The patient immediately received an intra-aortic balloon pump and percutaneous cardiopulmonary support. Right ventricular endomyocardial biopsy was performed in the acute phase and showed extensive eosinophilic inflammatory cell infiltration, severe interstitial edema and moderate myocardial necrosis. High-dose corticosteroids were administered. Because the patient's antibody titer against Toxocara canis was high and his symptoms had appeared after eating raw deer meat, the diagnosis was fulminant eosinophilic myocarditis caused by a hypersensitivity reaction to visceral larval migrans. After starting high-dose corticosteroids, the ejectionfraction dramatically improved, me eosinophilia decreased and the patient made a full recovery.

Original language	English
Pages (from-to)	1344-1348
Number of pages	5
Journal	Circulation Journal
Volume	73
Issue number	7
DOIs	https://doi.org/10.1253/circj.CJ-08-0334
Publication status	Published - Jul 2009

Keywords

Corticosteroids
Eosinophilia
Myocarditis
Toxocara canis
Visceral larva migrans

ASJC Scopus subject areas

Cardiology and Cardiovascular Medicine

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10.1253/circj.CJ-08-0334

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title = "Fulminant eosinophilic myocarditis associated with visceral larva migrans caused by Toxocara canis infection",

abstract = "A 19-year-old man was transferred to hospital because of myocarditis with cardiogenic shock. Echocardiography showed a left ventricular ejection fraction of 23.8% and an intermediate amount of pericardial effusion. The patient immediately received an intra-aortic balloon pump and percutaneous cardiopulmonary support. Right ventricular endomyocardial biopsy was performed in the acute phase and showed extensive eosinophilic inflammatory cell infiltration, severe interstitial edema and moderate myocardial necrosis. High-dose corticosteroids were administered. Because the patient's antibody titer against Toxocara canis was high and his symptoms had appeared after eating raw deer meat, the diagnosis was fulminant eosinophilic myocarditis caused by a hypersensitivity reaction to visceral larval migrans. After starting high-dose corticosteroids, the ejectionfraction dramatically improved, me eosinophilia decreased and the patient made a full recovery.",

keywords = "Corticosteroids, Eosinophilia, Myocarditis, Toxocara canis, Visceral larva migrans",

author = "Kenki Enko and Takeshi Tada and Ohgo, {Keiko O.} and Satoshi Nagase and Kazufumi Nakamura and Kei Ohta and Shingo Ichiba and Yoshihito Ujike and Yukifumi Nawa and Haruhiko Maruyama and Tohru Ohe and Kusano, {Kengo F.}",

year = "2009",

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doi = "10.1253/circj.CJ-08-0334",

language = "English",

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AU - Enko, Kenki

AU - Tada, Takeshi

AU - Ohgo, Keiko O.

AU - Nagase, Satoshi

AU - Nakamura, Kazufumi

AU - Ohta, Kei

AU - Ichiba, Shingo

AU - Ujike, Yoshihito

AU - Nawa, Yukifumi

AU - Maruyama, Haruhiko

AU - Ohe, Tohru

AU - Kusano, Kengo F.

PY - 2009/7

Y1 - 2009/7

N2 - A 19-year-old man was transferred to hospital because of myocarditis with cardiogenic shock. Echocardiography showed a left ventricular ejection fraction of 23.8% and an intermediate amount of pericardial effusion. The patient immediately received an intra-aortic balloon pump and percutaneous cardiopulmonary support. Right ventricular endomyocardial biopsy was performed in the acute phase and showed extensive eosinophilic inflammatory cell infiltration, severe interstitial edema and moderate myocardial necrosis. High-dose corticosteroids were administered. Because the patient's antibody titer against Toxocara canis was high and his symptoms had appeared after eating raw deer meat, the diagnosis was fulminant eosinophilic myocarditis caused by a hypersensitivity reaction to visceral larval migrans. After starting high-dose corticosteroids, the ejectionfraction dramatically improved, me eosinophilia decreased and the patient made a full recovery.

AB - A 19-year-old man was transferred to hospital because of myocarditis with cardiogenic shock. Echocardiography showed a left ventricular ejection fraction of 23.8% and an intermediate amount of pericardial effusion. The patient immediately received an intra-aortic balloon pump and percutaneous cardiopulmonary support. Right ventricular endomyocardial biopsy was performed in the acute phase and showed extensive eosinophilic inflammatory cell infiltration, severe interstitial edema and moderate myocardial necrosis. High-dose corticosteroids were administered. Because the patient's antibody titer against Toxocara canis was high and his symptoms had appeared after eating raw deer meat, the diagnosis was fulminant eosinophilic myocarditis caused by a hypersensitivity reaction to visceral larval migrans. After starting high-dose corticosteroids, the ejectionfraction dramatically improved, me eosinophilia decreased and the patient made a full recovery.

KW - Corticosteroids

KW - Eosinophilia

KW - Myocarditis

KW - Toxocara canis

KW - Visceral larva migrans

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Fulminant eosinophilic myocarditis associated with visceral larva migrans caused by Toxocara canis infection

Abstract

Keywords

ASJC Scopus subject areas

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