[Dilated cardiomyopathy and hypereosinophilia in a young female patient]. / Miocardiopatía dilatada e hipereosinofilia en una paciente joven.

A 23-year-old white woman was admitted because of cardiac failure (functional class II), palpable purpura and hypereosinophilia. A month before, she had been operated due to right femoral embolus. In this occasion, enhanced cardiac size on X-ray film of the chest and 12,300 eosinophils/mm3 were observed. She was asthmatic from her childhood. The laboratory data did not detect an etiology of hypereosinophilia. Serologic test for collagenous diseases, Chagas, hydatidosis, toxocariasis, Coxsackie B 1-6 and cytomegalovirus were not considered reactive. Three parasitologic stool examinations were negative. Duodenal sounding was negative. Myocardial dilatation was confirmed by mode M and B echocardiogram (60 mm left ventricular diastolic diameter), and by 99Tc radiocardiogram (left ventricular ejection fraction -LVEF-: 29% and right VEF: 15%). On the 25th day of treatment with 16-beta-methyl-prednisone (1 mg/K/d), eosinophil count was reduced to 300/mm3. On the 45th day, clinical improvement, dilatation reduction on echocardiogram and a 32% LVEF were observed. On the 10th month, the patient has no signs or symptoms of cardiac failure under treatment. Although endomyocardial biopsy was not performed but considering the low prevalence of myocardial dilatation at such an age, it is possible to postulate that the patient has undergone the initial necrotic stage (dilated cardiomyopathy) and the intermedial thrombotic stage (femoral embolus) of the eosinophilic endomyocardial disease.