EVOLUTION TO DILATED CARDIOMYOPATHY FROM ACUTE EOSINOPHILIC PANCARDITIS IN CHURG-STRAUSS-SYNDROME

We describe the clinical manifestations of a patient with Churg-Straus s syndrome who presented with severe acute cardiac involvement and who se disease evolved to dilated cardiomyopathy (DCM), with special refer ence to the histopathological findings. Endomyocardial biopsies, condu cted sequentially, three times within 10 months, revealed severe eosin ophilic endomyocarditis in the acute phase, interstitial fibrosis in t he subacute phase, and endocardial thickening with mural thrombi, at 1 0 months. Although acute inflammation associated with elevation of eos inophil granule proteins subsided with steroid therapy, left ventricul ar dilatation with reduced contractility progressed. A subgroup of DCM is not considered to be idiopathic but, rather, an aftereffect of hyp ereosinophilic heart disease.