A endocardite de Loeffler é um tipo raro de doença do músculo do coração que o impede de relaxar e encher de forma adequada. Ela é caracterizada por um número muito alto de eosinófilos (um tipo de glóbulo branco) no sangue e pelo espessamento e endurecimento fibroso da camada interna do coração (o endocárdio). Além disso, geralmente há a presença de grandes coágulos, que costumam ficar fixados nas paredes das câmaras inferiores do coração (os ventrículos). Isso pode levar a complicações cardiovasculares graves, como insuficiência cardíaca (quando o coração não consegue bombear sangue suficiente para o corpo) e tromboembolismo (formação de coágulos que se soltam e bloqueiam vasos sanguíneos em outros locais). Os sintomas incluem inchaço (edema), cansaço extremo (fadiga) e falta de ar. Geralmente, essa condição é resultado de danos nos tecidos causados pelos eosinófilos. Ela está associada a condições como a síndrome hipereosinofílica idiopática (um excesso de eosinófilos sem causa conhecida), leucemia eosinofílica crônica (um tipo de câncer do sangue), carcinoma (um tipo de câncer) ou linfoma (também um tipo de câncer).
Introdução
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A endocardite de Loeffler é um tipo raro de doença do músculo do coração que o impede de relaxar e encher de forma adequada. Ela é caracterizada por um número muito alto de eosinófilos (um tipo de glóbulo branco) no sangue e pelo espessamento e endurecimento fibroso da camada interna do coração (o endocárdio). Além disso, geralmente há a presença de grandes coágulos, que costumam ficar fixados nas paredes das câmaras inferiores do coração (os ventrículos). Isso pode levar a complicações cardiovasculares graves, como insuficiência cardíaca (quando o coração não consegue bombear sangue suficiente para o corpo) e tromboembolismo (formação de coágulos que se soltam e bloqueiam vasos sanguíneos em outros locais). Os sintomas incluem inchaço (edema), cansaço extremo (fadiga) e falta de ar. Geralmente, essa condição é resultado de danos nos tecidos causados pelos eosinófilos. Ela está associada a condições como a síndrome hipereosinofílica idiopática (um excesso de eosinófilos sem causa conhecida), leucemia eosinofílica crônica (um tipo de câncer do sangue), carcinoma (um tipo de câncer) ou linfoma (também um tipo de câncer).
Escala de raridade
<1/50kMuito rara
1/20kRara
1/10kPouco freq.
1/5kIncomum
1/2k
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Sinais e sintomas
O que aparece no corpo e com que frequência cada sintoma acontece
Partes do corpo afetadas
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Características mais comuns
Os sintomas variam de pessoa para pessoa. Abaixo estão as 27 características clínicas mais associadas, ordenadas por frequência.
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Genética e causas
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Diagnóstico
Os sinais que médicos procuram e os exames que confirmam
Tratamento e manejo
Remédios, cuidados de apoio e o que precisa acompanhar
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Publicações mais relevantes
[Incidental finding of negative T waves: a case of endomyocardial fibrosis].
We present the case of a 58-year-old man with negative T waves in the inferior and lateral leads observed on a routine ECG in the context of persistent peripheral eosinophilia, 6 months after an intestinal parasitic infection. The diagnostic workup excluded coronary artery disease and led to a diagnosis of endomyocardial fibrosis with apical thrombosis. Endomyocardial fibrosis, also known as Loeffler endocarditis, represents the cardiac involvement of the hypereosinophilic syndrome, resulting in a cardiomyopathy with a restrictive phenotype. After initiating specific therapy, further investigations identified chronic eosinophilic leukemia as the underlying cause of hypereosinophilia. The patient remained asymptomatic regarding heart failure manifestations. Additionally, diastolic function was pseudo normal on transthoracic echocardiography, with no restrictive pattern, and troponin and natriuretic peptide levels were only mildly elevated. The moderate peripheral eosinophilia was firstly attributed to the recent parasitic infection, supported by the decrease in eosinophil count following treatment with metronidazole. Cardiac involvement occurred relatively shortly after the onset of peripheral eosinophilia (approximately 6 months). Early diagnosis through advanced cardiac imaging allowed the detection of this condition before irreversible myocardial damage occurred and facilitated the initiation of targeted therapy for both ventricular thrombosis and cardiomyopathy.
From bone marrow to the heart: a case report of cardiac involvement in myeloproliferative-associated hypereosinophilic syndrome.
A 36-year-old man with marked eosinophilia presented with fatigue and dyspnea. Echocardiography revealed biventricular apical thickening and thrombi, confirmed by contrast imaging. Cardiac magnetic resonance demonstrated global systolic dysfunction,myocardial edema, and subendocardial late gadolinium enhancement, consistent with early-thrombotic-stage Loeffler endocarditis. Bone marrow biopsy identified a FIP1L1-PDGFRA fusion, confirming myeloproliferative hypereosinophilic syndrome. High-dose corticosteroids followed by imatinib induced hematologic and cardiac improvement, with complete thrombus resolution at follow-up. Τhis case illustrates that the integration of advanced multimodal imaging with targeted genetic analysis can reliably establish the diagnosis of Loeffler endocarditis, obviating the need for invasive histopathological confirmation in appropriately selected patients.
Sézary syndrome as an unusual cause of Loeffler endocarditis.
Loeffler endocarditis in hypereosinophilic syndrome, the paradox of absent peripheral eosinophilia: a case report.
Loeffler endocarditis is a cardiac disease characterized by infiltration of eosinophils in hypereosinophilic syndrome (HES), progressing through acute necrotic, thrombotic, and fibrotic stages. It can ultimately lead to heart failure and restrictive cardiomyopathy. Early recognition, multidisciplinary approach, and accurate treatment are crucial to prevent these complications. A 51-year-old man presented with dyspnoea and chest discomfort. Imaging revealed a large left ventricular (LV) thrombus, a reduced LV ejection fraction (LVEF 28%), and a typical 'double-V pattern' of endomyocardial fibrosis. Despite characteristic imaging findings of Loeffler endocarditis, the absence of peripheral eosinophilia reduced clinical suspicion. Coronary disease was excluded by CT coronary angiography. Extended bloodwork for infectious, autoimmune, oncologic, and HES-related diseases remained negative. Myeloperoxidase tested positive; however, there were no clinical findings suggestive of eosinophilic granulomatosis with polyangiitis. Subsequently, a bone marrow biopsy confirmed eosinophilia, establishing the diagnosis of Loeffler endocarditis. The patient was treated with anticoagulation, heart failure therapy, and prednisone. At 6-month follow-up, LVEF improved slightly to 35% but the typical V-shaped LV thrombus persisted, and heart failure symptoms (NYHA III) remained. Loeffler endocarditis is an eosinophil-mediated disease but may present without peripheral eosinophilia, particularly in longstanding cases of HES. This underscores the importance of cardiac imaging, bone marrow evaluation, and multidisciplinary collaboration in suspected cases to ensure timely diagnosis and treatment, thereby preventing disease progression.
Loeffler endocarditis revealing chronic eosinophilic leukaemia with FIP1L1-PDGFRA rearrangement: a case report.
Hypereosinophilic syndrome (HES) is an infrequent multisystemic disorder with a serious prognosis, defined by persistent marked eosinophilia (>1500 eosinophils/mm3) associated with organ damage from eosinophil-mediated cytotoxicity. Cardiac involvement is a significant and unpredictable complication of hypereosinophilic syndrome, particularly prevalent in patients carrying the FIP1L1-PDGFRA fusion. Reported is a case of chronic eosinophilic leukaemia (CEL) with a FIP1L1-PDGFRA rearrangement, diagnosed in a 31-year-old patient presenting with Loeffler endocarditis. Intracardiac thrombi and embolic cerebral infarctions complicated the case. The patient demonstrated haematological remission following chemotherapy, and anticoagulation treatment led to thrombi resolution. This case highlights that Loeffler endocarditis can present as the primary and sole manifestation of chronic eosinophilic leukaemia. Effective collaboration between cardiologists and internists is crucial for timely diagnosis and comprehensive management, ultimately resulting in enhanced outcomes.
Publicações recentes
[Incidental finding of negative T waves: a case of endomyocardial fibrosis].
A diagnostic challenge: Loeffler endocarditis without peripheral eosinophilia.
From bone marrow to the heart: a case report of cardiac involvement in myeloproliferative-associated hypereosinophilic syndrome.
Loeffler endocarditis in hypereosinophilic syndrome, the paradox of absent peripheral eosinophilia: a case report.
[Clinical analysis of six eosinophilia cases with Löeffler endocarditis as the main clinical feature].
📚 EuropePMC65 artigos no totalmostrando 66
[Incidental finding of negative T waves: a case of endomyocardial fibrosis].
Giornale italiano di cardiologia (2006)A diagnostic challenge: Loeffler endocarditis without peripheral eosinophilia.
Journal of echocardiographyFrom bone marrow to the heart: a case report of cardiac involvement in myeloproliferative-associated hypereosinophilic syndrome.
Future cardiologyLoeffler endocarditis in hypereosinophilic syndrome, the paradox of absent peripheral eosinophilia: a case report.
European heart journal. Case reports[Clinical analysis of six eosinophilia cases with Löeffler endocarditis as the main clinical feature].
Zhonghua xue ye xue za zhi = Zhonghua xueyexue zazhiMultimodal Imaging in the Diagnosis of Late-Stage Loeffler Endocarditis.
JACC. Case reportsSézary syndrome as an unusual cause of Loeffler endocarditis.
Revista espanola de cardiologia (English ed.)Diagnosis of Loeffler Endocarditis in a Patient with a Cerebrovascular Event.
Turk Kardiyoloji Dernegi arsivi : Turk Kardiyoloji Derneginin yayin organidirUtility of superb microvascular imaging in evaluating intracardiac thrombus in Loeffler endocarditis.
Journal of medical ultrasonics (2001)Loeffler Endocarditis with Antineutrophil Cytoplasmic Antibody-associated Vasculitis after COVID-19 Vaccination.
Internal medicine (Tokyo, Japan)Loeffler endocarditis revealing chronic eosinophilic leukaemia with FIP1L1-PDGFRA rearrangement: a case report.
European heart journal. Case reportsA case description of chronic eosinophilic leukemia with loeffler endocarditis initially characterized by cerebral infarction: the role of 2-dimensional speckle tracking echocardiography in diagnosis.
Quantitative imaging in medicine and surgeryCase Report: Loeffler endocarditis as a cause of left ventricular thrombosis in young women: a case study and literature review.
Frontiers in cardiovascular medicineMultiple Cerebral Infarcts and Encephalopathy as the First Clinical Manifestations of Hypereosinophilic Syndrome: A Case Report and Narrative Review.
Pulse (Basel, Switzerland)Incessant Ventricular Tachycardia: An Atypical Presentation of Chronic Eosinophilic Leukemia.
JACC. Case reportsA case report of right-sided heart failure secondary to JAK2-mutation Loeffler endocarditis.
ESC heart failureAtrial myxoma as a mimicker of intracardiac thrombus in Behçet's syndrome: a case study with histopathological confirmation.
Clinical and experimental rheumatologyHypereosinophilia and Left Ventricular Thrombus: A Case Report and Literature Review.
CureusEchocardiographic monitoring of myocardial function in a female patient with right heart Loeffler endocarditis at thrombotic stage after Epstein-Barr-virus infection.
The international journal of cardiovascular imagingIn-Depth Review of Loeffler Endocarditis: What Have We Learned?
Journal of inflammation researchTwo Different Clinical Presentations and Stages of Loeffler Endocarditis Diagnosed by Multimodality Investigations.
CASE (Philadelphia, Pa.)Eosinophilic granulomatosis with polyangiitis, asthma as the first symptom, and subsequent Loeffler endocarditis: A case report.
World journal of clinical casesMyocardial acoustics-assisted diagnosis of right ventricular Loeffler endocarditis.
Quantitative imaging in medicine and surgeryHypereosinophilic Syndrome Endocarditis With Severe Biventricular Failure Complicated by Sepsis: A Challenging Case.
CureusContrast Echocardiography with Different Probes: A New Attempt at the Follow-Up of Apical Thrombus in Loeffler Endocarditis.
Anatolian journal of cardiologyFIP1L1-PDGFRα-Positive Loeffler Endocarditis-A Distinct Cause of Heart Failure in a Young Male: The Role of Multimodal Diagnostic Tools.
Diagnostics (Basel, Switzerland)Case report: Different clinical manifestations of the rare Loeffler endocarditis.
Frontiers in cardiovascular medicineSystemic thrombo-embolic events in a middle-aged male with Loeffler endocarditis without peripheral eosinophilia-a case report.
BMC cardiovascular disordersLeft Ventricular Assist Device Evaluation for Congestive Heart Failure With Hypereosinophilic Syndrome in a 76-Year-Old Male.
CureusLoeffler Endocarditis Causing Heart Failure with Preserved Ejection Fraction (HFpEF): Characteristic Images and Diagnostic Pathway.
Diagnostics (Basel, Switzerland)Case 305: Loeffler Endocarditis.
RadiologyHypereosinophilic Syndrome with Advanced-Stage Loeffler Endocarditis.
CASE (Philadelphia, Pa.)Mixed-Etiology Restrictive Cardiomyopathy (Desminopathy and Hemochromatosis) with Complex Liver Lesions.
GenesHypereosinophilic syndrome with cardiac infiltration and congestive heart failure in a cat.
Journal of veterinary cardiology : the official journal of the European Society of Veterinary CardiologyLoeffler endocarditis with intracardiac thrombus: case report and literature review.
BMC cardiovascular disorders[A case report of Löeffler endocarditis].
Zhonghua xin xue guan bing za zhiNormalization of left ventricular filling pressure after cardiac surgery for the Loeffler's endocarditis: a case report.
European heart journal. Case reportsA case of hypereosinophilic syndrome with Loeffler endocarditis successfully bridged to heart transplantation by biventricular mechanical support.
Artificial organsFollow-up CMR in a case of Loeffler endocarditis.
Clinical case reportsLoeffler Endocarditis as a Manifestation of Paraneoplastic Hypereosinophilia.
CASE (Philadelphia, Pa.)Right sided heart failure secondary to hypereosinophilic cardiomyopathy - clinical manifestation and diagnostic pathway.
Radiology case reportsLoeffler Endocarditis and Associated Parasitosis: A Diagnostic Challenge.
CureusLoeffler Endocarditis: A Manifestation of Hypereosinophilic Syndrome.
CASE (Philadelphia, Pa.)Loeffler Endocarditis in Idiopathic Hypereosinophilic Syndrome Demonstrated by Magnetic Resonance Imaging Effectively Treated by Corticosteroids.
Acta Cardiologica SinicaMorphologically proved ANCA positive Loeffler's pancarditis: medical and surgical treatment.
Terapevticheskii arkhivLoeffler's endocarditis with isolated left ventricular involvement on cardiac MRI.
BMJ case reportsRecurrent myocardial infarction in a 50-year-old woman.
Heart (British Cardiac Society)Loeffler Endocarditis: A Diagnosis Made with Cardiovascular Magnetic Resonance.
Journal of cardiovascular imagingLoeffler endocarditis associated with a massive right intraventricular thrombus.
Intensive care medicineSuccessful Medical Management of a Rare Loeffler Endocarditis Case.
Korean circulation journalLoeffler endocarditis as a rare cause of heart failure with preserved ejection fraction: A case report and review of literature.
MedicineA Case of Loeffler Endocarditis That Showed Endomyocardial Systolic Dysfunction Detected by Layer Specific Strain Analysis.
International heart journalLoeffler Endocarditis: A Unique Presentation of Right-Sided Heart Failure Due to Eosinophil-Induced Endomyocardial Fibrosis.
Clinical medicine insights. Case reportsLoeffler endocarditis in chronic eosinophilic leukemia with FIP1L1/PDGFRA rearrangement: full recovery with low dose imatinib.
The Korean journal of internal medicineUsefulness of three-dimensional echocardiography in the assessment of valvular involvement in Loeffler endocarditis.
Echocardiography (Mount Kisco, N.Y.)Cardiac involvements in hypereosinophilia-associated syndrome: Case reports and a little review of the literature.
Echocardiography (Mount Kisco, N.Y.)When Hypereosinophilia Leads to Stroke.
European journal of case reports in internal medicineLoeffler endocarditis in young woman - a case report.
Polski merkuriusz lekarski : organ Polskiego Towarzystwa LekarskiegoANCA-negative eosinophilic granulomatosis with polyangitis (EGPA) manifesting as a large intracardiac thrombus and glomerulonephritis with angionecrosis.
BMJ case reportsPaediatric presentation of cardiac involvement in hypereosinophilic syndrome.
Cardiology in the youngLoeffler endocarditis in a patient with non-Hodgkin's lymphoma.
Kardiologia polskaLoeffler endocarditis: silent right ventricular myocardium!
Wiener klinische WochenschriftHematological dyspnea: A rare cause with gratifying recovery.
Journal of cardiology casesRestrictive myocardium with an unusual pattern of apical hypertrophic cardiomyopathy.
Cardiovascular pathology : the official journal of the Society for Cardiovascular PathologyBiopsy-proven Loeffler endocarditis successfully treated with steroids.
CirculationDiagnosis and resolution of Löeffler endocarditis secondary to eosinophilic granulomatosis with polyangiitis demonstrated by cardiac magnetic resonance-T2 mapping.
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Referências e fontes
Bases de dados externas citadas neste artigo
Publicações científicas
Artigos indexados no PubMed ligados a esta doença no grafo RarasNet — título, periódico e PMID direto da fonte, sem intermediação de IA.
- [Incidental finding of negative T waves: a case of endomyocardial fibrosis].
- From bone marrow to the heart: a case report of cardiac involvement in myeloproliferative-associated hypereosinophilic syndrome.
- Sézary syndrome as an unusual cause of Loeffler endocarditis.
- Loeffler endocarditis in hypereosinophilic syndrome, the paradox of absent peripheral eosinophilia: a case report.
- Loeffler endocarditis revealing chronic eosinophilic leukaemia with FIP1L1-PDGFRA rearrangement: a case report.
- A diagnostic challenge: Loeffler endocarditis without peripheral eosinophilia.
- [Clinical analysis of six eosinophilia cases with Löeffler endocarditis as the main clinical feature].
Bases de dados e fontes oficiais
Identificadores e referências canônicas usadas para montar este verbete.
- ORPHA:75566(Orphanet)
- MONDO:0019159(MONDO)
- GARD:18929(GARD (NIH))
- Busca completa no PubMed(PubMed)
- Artigo Wikipedia(Wikipedia)
- Q4710773(Wikidata)
Dados compilados pelo RarasNet a partir de fontes abertas (Orphanet, OMIM, MONDO, PubMed/EuropePMC, ClinicalTrials.gov, DATASUS, PCDT/MS). Este conteúdo é informativo e não substitui avaliação médica.
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