Early diagnosis by endomyocardial biopsy and prompt treatment with high-dose corticosteroids can successfully reverse the rapidly progressive and often fatal course of acute necrotizing eosinophilic myocarditis.
May support steroids in biopsy-proven eosinophilic myocarditis; leaves open need for controlled trials.
Acute necrotizing eosinophilic myocarditis is the most severe form of eosinophilic myocarditis, or hypersensitivity myocarditis, and is characterized by rapidly progressive congestive heart failure followed by fulminant clinical deterioration that is nearly always fatal. A 55-year-old previously healthy patient with acute necrotizing eosinophilic myocarditis was diagnosed by early myocardial biopsy and successfully treated with corticosteroids. Throughout his hospitalization, the eosinophil count in the peripheral blood remained normal (56-201/mm3). Early stage corticosteroid therapy can have dramatic effects in acute necrotizing eosinophilic myocarditis and early diagnosis by endomyocardial biopsy is recommended.
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Watanabe et al. (2001) studied this question.
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