Churg-Strauss syndrome complicated by eosinophilic endomyocarditis

A 34-year-old woman with asthma had increasing dyspnea on exertion for 9 mo nths and new-onset mononeuritis multiplex, An examination demonstrated sinu s tachycardia, elevated jugular venous pressure, and a tender nonpulsatile liver. The leukocyte count was 15.8 x 10(9)/L, with 23% eosinophils. Echoca rdiography revealed a laminated thrombus obliterating much of the right ven tricular cavity, with encasement of the tricuspid valve. Ultrafast computed tomography showed no evidence of pulmonary emboli, Biopsy specimens of ski n nodules revealed extravascular palisading granulomas, The thrombus was re fractory to corticosteroids, and right ventricular thrombectomy was perform ed. To our knowledge, this is the third reported case of Churg-Strauss synd rome with thrombotic complications from coexistent eosinophilic endomyocard itis. in an asthmatic patient with chronic dyspnea, eosinophilic tissue inf iltration, and neuropathy, Churg-Strauss syndrome should be considered; eva luation for cardiac involvement may be warranted.