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Case Report
A case of hypereosinophilic syndrome with eosinophilic myocarditis secondary to nabumetone
1 Resident Physician, Department of Internal Medicine and Pediatrics, Rush University Medical Center, Chicago, IL, USA
2 Assistant Professor, Department of Internal Medicine, Rush University Medical Center, Chicago, IL, USA
3 Assistant Professor, Department of Pathology, Rush University Medical Center, Chicago, IL, USA
Address correspondence to:
Andrew Vissing
1645 W. Jackson Blvd, Suite 215, Chicago, IL,
USA
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Article ID: 101151Z01AV2020
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Vissing A, Jain S, Bai C, Ward N. A case of hypereosinophilic syndrome with eosinophilic myocarditis secondary to nabumetone. Int J Case Rep Images 2020;11:101151Z01AV2020.ABSTRACT
Introduction: Hypereosinophilic syndromes are a group of disorders defined by an absolute eosinophil count greater than 1.5 × 109/L that leads to eosinophil-mediated end-organ damage. Cardiac involvement can range from asymptomatic inflammation of the myocardium to endomyocardial fibrosis and irreversible constrictive cardiomyopathy.
Case Report: We present the case of a patient who presented with confusion and was found to have an absolute eosinophil count of 8.08 × 109/L as well as clinical findings consistent with eosinophilic myocarditis. It was determined that her clinical presentation was due to a new medication she had taken, nabumetone. Other causes of hypereosinophilia were ruled out. She improved with two days of pulse dose methylprednisolone and subsequent prednisone taper with complete resolution of her cardiomyopathy and normalization of her absolute eosinophil count.
Conclusion: While there are no guidelines available for the treatment of eosinophilic myocarditis, corticosteroids should be considered in patients with evidence of cardiomyopathy in the setting of hypereosinophilia. Hypereosinophilic syndrome is an uncommonly recognized adverse event of non-steroidal anti-inflammatory drug (NSAID) therapy.
Keywords: Eosinophilic myocarditis, Hypereosinophilic syndrome, Nabumetone
SUPPORTING INFORMATION
Author Contributions
Andrew Vissing - Substantial contributions to conception and design, Drafting the article, Final approval of the version to be published
Shivi Jain - Substantial contributions to conception and design, Revising it critically for important intellectual content, Final approval of the version to be published
Charlotte Bai - Revising it critically for important intellectual content, Final approval of the version to be published
Nicholas Ward - Acquisition of data, Revising it critically for important intellectual content, Final approval of the version to be published
Guaranter of SubmissionThe corresponding author is the guarantor of submission.
Source of SupportNone
Consent StatementWritten informed consent was obtained from the patient for publication of this article.
Data AvailabilityAll relevant data are within the paper and its Supporting Information files.
Conflict of InterestAuthors declare no conflict of interest.
Copyright© 2020 Andrew Vissing et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.
