Online ISSN: 2187-2988 Print ISSN: 0911-1794
特定非営利活動法人日本小児循環器学会 Japanese Society of Pediatric Cardiology and Cardiac Surgery
Pediatric Cardiology and Cardiac Surgery 39(2): 99-105 (2023)
doi:10.9794/jspccs.39.99

症例報告Case Report

心室細動で発症した好酸球性心筋炎の1歳女児例Eosinophilic Myocarditis Presenting with Ventricular Fibrillation in a 1-Year-Old Girl

1国立成育医療研究センター 循環器科Division of Cardiology, National Center for Child Health and Development ◇ Tokyo, Japan

2国立成育医療研究センター 病理診断部病理診断科Division of Pathology, National Center for Child Health and Development ◇ Tokyo, Japan

3国立成育医療研究センター 総合アレルギー科Division of Allergy, National Center for Child Health and Development ◇ Tokyo, Japan

4国立成育医療研究センター 小児がんセンターChildren’s Cancer Center, National Center for Child Health and Development ◇ Tokyo, Japan

受付日:2022年12月24日Received: December 24, 2022
受理日:2023年4月4日Accepted: April 4, 2023
発行日:2023年8月1日Published: August 1, 2023
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過去に報告のない,心室細動で発症し自動体外式除細動器により救命された,特発性好酸球増多症候群に伴った好酸球性心筋炎の幼児例を経験した.本症例は経過中,心室細動を含めた不整脈の再発は認めなかった.入院当初血液検査での脳性ナトリウム利尿ペプチドの上昇と,心エコー上,少量の心嚢液貯留と僧帽弁の逆流を認めたが,ステロイドなどの治療介入を要さず,経過観察のみで回復した.末梢血好酸球数は低下したが,正常化はしておらず,心臓MRIの遅延造影所見も残存しており,外来での慎重な経過観察を必要としている.

Here, we report a previously unreported infant with idiopathic hypereosinophilic syndrome-associated eosinophilic myocarditis who developed ventricular fibrillation and was rescued by an automated external defibrillator. The patient had no recurrence of arrhythmia (including ventricular fibrillation). Blood tests initially revealed an elevated brain natriuretic peptide level, and echocardiography revealed small amounts of pericardial effusion and mitral valve regurgitation. Fortunately, the patient recovered without necessitating therapeutic intervention (e.g., steroids). The eosinophil number decreased, but it did not normalize, and late gadolinium enhancement findings on cardiac magnetic resonance imaging remained positive. Therefore, careful outpatient follow-up is required.

Key words: eosinophilic myocarditis; ventricular fibrillation; idiopathic hypereosinophilic syndrome

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