Fatal sulfasalazine-induced eosinophilic myocarditis in a patient with periodic fever syndrome

ABSTRACT

The aim of this paper is to report the first case of drug-induced eosinophilic myocarditis [EM] in a patient with hereditary periodic fever syndrome [PFS]. Case A 28-year-old man with hyper-IgD syndrome, one of the PFS, developed a sulfasalazine-induced systemic hypersensitivity reaction complicated by EM. Thirteen days after sulfasalazine introduction, which had been given for arthritis, the patient developed fever, facial/neck edema, rash and cardiogenic shock, and died within 8 h. The autopsy revealed hemophagocytosis, while acute heart failure caused by necrotizing EM was established as the cause of death. This was a case of drug-induced EM in a patient with PFS that had an atypical presentation, rapid evolution and poor outcome: