JACC. Case reports · 2026
Eosinophilic Cardiomyopathy in Eosinophilic Granulomatosis With Polyangiitis After Dupilumab Therapy.
Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Agredano Issey, Michiels Vincent, Argacha Jean-François, Verbrugge Frederik H, Tanaka Kaoru, Lefesvre Pierre, Cosyns Bernard
Аннотация
BACKGROUND: Dupilumab, an IL-4Rα antagonist used in type 2 inflammatory diseases, is associated with transient peripheral eosinophilia, yet progression to eosinophilic granulomatosis with polyangiitis (EGPA) remains rare.
CASE SUMMARY: A 64-year-old man presented with acute chest pain, dyspnea, marked hypereosinophilia, elevated cardiac biomarkers, and systemic symptoms 3 months after dupilumab initiation. Echocardiography and cardiac magnetic resonance imaging demonstrated left ventricular dysfunction, and endomyocardial biopsy confirmed eosinophilic myocarditis. High-dose corticosteroids and cyclophosphamide led to rapid clinical improvement.
DISCUSSION: This case shows severe eosinophilic myocarditis in the context of dupilumab therapy. Current literature suggests biologic therapy may unmask underlying EGPA rather than directly induce vasculitis, emphasizing the need for vigilance.
TAKE-HOME MESSAGES: Dupilumab-associated eosinophilia warrants careful eosinophil monitoring. New systemic or cardiac symptoms should prompt evaluation for EGPA, using multimodality imaging with a low threshold for performing endomyocardial biopsy.
CASE SUMMARY: A 64-year-old man presented with acute chest pain, dyspnea, marked hypereosinophilia, elevated cardiac biomarkers, and systemic symptoms 3 months after dupilumab initiation. Echocardiography and cardiac magnetic resonance imaging demonstrated left ventricular dysfunction, and endomyocardial biopsy confirmed eosinophilic myocarditis. High-dose corticosteroids and cyclophosphamide led to rapid clinical improvement.
DISCUSSION: This case shows severe eosinophilic myocarditis in the context of dupilumab therapy. Current literature suggests biologic therapy may unmask underlying EGPA rather than directly induce vasculitis, emphasizing the need for vigilance.
TAKE-HOME MESSAGES: Dupilumab-associated eosinophilia warrants careful eosinophil monitoring. New systemic or cardiac symptoms should prompt evaluation for EGPA, using multimodality imaging with a low threshold for performing endomyocardial biopsy.