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Background: Acute ST elevation myocardial infarction (STEMI) is a medical emergency and is most commonly due to atherosclerotic plaque rupture and occlusion of coronary vessels. This case demonstrates that eosinophilic granulomatosis with polyangiitis (EGPA) myocarditis can mimic acute STEMI.
Case Summary: A 44-year-old woman presented with acute chest pain, shortness of breath, and collapse with ST elevation on electrocardiography. Coronary angiogram showed unobstructed coronaries and chest film revealed left-sided consolidation. Together with a thorough history, serum eosinophilia, cardiac magnetic resonance (CMR), and computated tomography imaging, the patient was diagnosed with acute EGPA myocarditis. She responded tremendously to steroid and cyclophosphamide immunosuppression and subsequent CMR imaging demonstrated complete resolution of myocarditis.
Discussion: CMR played a crucial role in the diagnosis and follow-up of this rare presentation. In patients who present as a STEMI but show unobstructed coronary vessels, EGPA may be a possible diagnosis.
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http://dx.doi.org/10.1093/ehjcr/ytz161 | DOI Listing |
J Allergy Clin Immunol Pract
September 2025
Division of Pulmonary, Critical Care, and Sleep Medicine, National Jewish Health, Denver, Colorado, USA. Electronic address:
Background: Several real-world cohorts and numerous case reports investigating benralizumab outcomes in eosinophilic granulomatosis with polyangiitis have been published. These studies complement the limited clinical trial data available by providing early insights on benralizumab use in a broader, real-world population.
Objective: The objective of this systematic literature review (SLR) was to provide an overview of the real-world outcomes of benralizumab in EGPA.
J Med Cases
August 2025
Department of Hematology/Oncology, Mayo Clinic, Jacksonville, FL, USA.
Hypereosinophilic syndrome (HES) is a hematologic disorder characterized by an increased absolute eosinophil count (AEC) that can lead to tissue infiltration and damage. Idiopathic HES (iHES) comprises a subset of patients with HES, in which a reactive cause such as infections or an inflammatory process cannot be identified, and clonality is not demonstrable. iHES remains a challenge to treat since there is no specific mutation to target.
View Article and Find Full Text PDFJ Allergy Clin Immunol Glob
November 2025
Department of Rheumatology, Seirei Hamamatsu General Hospital, Shizuoka, Japan.
Eosinophilic granulomatosis with polyangiitis can manifest without eosinophilia and eosinophilic infiltration during benralizumab treatment, emphasizing the need for clinical vigilance beyond eosinophil counts.
View Article and Find Full Text PDFEur Heart J Case Rep
August 2025
Division of Cardiovascular Medicine, University of Virginia, PO Box 8000662, Charlottesville, VA 22908, USA.
Background: Immune checkpoint inhibitors (ICIs) have revolutionized cancer treatment but are associated with various adverse effects, including myocarditis, with mortality rates up to 50%. We report a case of fatal ICI-related fulminant eosinophilic myo-pericarditis complicated by tamponade in a 69-year-old man with metastatic lung adenocarcinoma.
Case Summary: Two weeks after receiving one dose of pembrolizumab, the patient presented with sudden chest pain and dyspnoea.
HNO
September 2025
Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital and University of Zurich, Zurich, Switzerland.
Eosinophilic granulomatosis with polyangiitis (EGPA, previously known as Churg-Strauss syndrome) is an antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) often presenting with chronic rhinosinusitis, pulmonary infiltrates, gastrointestinal and cardiac disorders, or renal lesions. Sinonasal and inner ear manifestations are common, but other affections of the head and neck area are rarely reported. Here we report a case of a young woman with a histopathological diagnosis of eosinophil-rich granulomatous inflammation affecting solely the tongue without other local or systemic lesions.
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