Immunosuppressive therapy with prednisolone improved left ventricular ejection fraction from 27.4% to 47.9% and reduced myocardial inflammation in a patient with eosinophilic myocarditis.
Case Report (n=1)
No
Rapid pathological diagnosis of acute myocarditis using unfixed frozen tissue can lead to misdiagnosis; formalin-fixed paraffin-embedded tissue is recommended for accurate identification of eosinophilic myocarditis to guide appropriate immunosuppressive therapy.
Effect estimate: LVEF increase from 27.4% to 47.9% after treatment
Absolute Event Rate: 47.9% vs 27.4%
Acute myocarditis requires an urgent endomyocardial biopsy for an accurate diagnosis and appropriate therapeutic decision-making. We herein report the case of a 64-year-old man who presented with fever and progressive dyspnea and was initially diagnosed with acute myocarditis based on the clinical and imaging findings. A rapid pathological analysis of unfixed frozen tissue obtained from an endomyocardial biopsy suggested lymphocytic myocarditis; however, a subsequent examination of formalin-fixed paraffin-embedded tissue revealed extensive eosinophilic infiltration, thus confirming eosinophilic myocarditis. Clinical and functional improvements were observed after immunosuppressive therapy. This case highlights the diagnostic challenges associated with different tissue preservation techniques, emphasizing the limitations of a frozen section analysis.
Hirata et al. (Thu,) conducted a case report in acute myocarditis (n=1). immunosuppressive therapy with prednisolone vs. none was evaluated on improvement in left ventricular ejection fraction (LVEF) and reduction of myocardial inflammation by imaging and biopsy (LVEF increase from 27.4% to 47.9% after treatment). Immunosuppressive therapy with prednisolone improved left ventricular ejection fraction from 27.4% to 47.9% and reduced myocardial inflammation in a patient with eosinophilic myocarditis.