The MRI findings in Hypereosinophilic syndrome

  • Eiichi Yamamoto, Ehime University Graduate School of Medicine, Ehime,, Japan
  • Takashi Higaki, Ehime University Graduate School of Medicine, Ehime,, Japan
  • Osamu Matsuda, Ehime University Graduate School of Medicine, Ehime,, Japan
  • Takeshi Nakano, Ehime University Graduate School of Medicine, Ehime,, Japan
  • Yoshitaka Murakami, Ehime University Graduate School of Medicine, Ehime,, Japan
  • Kyoko Konishi, Ehime University Graduate School of Medicine, Ehime,, Japan
  • Ohta Masaaki, Ehime University Graduate School of Medicine, Ehime,, Japan
  • Eiichi Ishii, Ehime University Graduate School of Medicine, Ehime,, Japan

    • Hypereosinophilic syndrome(HES)is rare systemic disease,especilly in childhood that cause multiple organ failure by eosinophilic infiltration.We presented a 6-year-old girl with rapid onset of heart failure.We got results of the cardiac Magnetic resonance imaging(MRI) findings of HES and followed them before, during, and after treatment. This is a report on the MRI findings of muscle involvement in HES
    She started with symptoms of common cold, a poor complexion,a feeling of fatigue, and loss of appetite. One month after, she had cough very hard and mild fever(38ēC).She was seen in a family doctor. Laboratory analysis showed a leucocytosis of 297’000/μl with 95% eosinophils(280’000/μl), anemia of Hb. 7.9g/dl, and a thrombocytopenia of 80’000 /μl. She was admitted to our hospital.MRI of the brain showed high signal area that meant suspicious eosinophil infiltration.Echocardiography revealed severe mitral regurgitation by restriction of motion of the posterior leaflet with mass that suspicious endocardial fibrosis or thromobosis of the left ventricular. Cardiac MRI showed endocardial mass in the left ventricular that was high signal area on T1 and T2 weighted image .
    Hypereosinophilia was considered to be idiopathic.Thus,on the basis of the all findings,she was diagosised HES.
    The patient was given symptomatic treatment immediately.and chemotherapy with prednisolone,hydroxyurea, vincristine and cyclosporine.After 1year 6months of treatment, she attained a complete remission.After treatment,cardiac MRI showed residual disease and Left ventricular performance.