Article Text

Download PDFPDF
CASE REPORT
Myopericarditis as a presentation of eosinophilic granulomatosus with polyangiitis (EGPA)
  1. Mrinalini Dey1,2,
  2. Jagdish Nair2,
  3. Rajiv Sankaranarayanan3 and
  4. Prathap Kanagala3
  1. 1 Department of Musculoskeletal Biology I, Institute of Ageing and Chronic Disease, University of Liverpool Faculty of Health and Life Sciences, Liverpool, UK
  2. 2 Department of Academic Rheumatology, Aintree University Hospitals NHS Foundation Trust, Liverpool, UK
  3. 3 Department of Cardiology, Aintree University Hospitals NHS Foundation Trust, Liverpool, UK
  1. Correspondence to Dr Mrinalini Dey, mrinalini.dey{at}nhs.net

Abstract

A 60-year-old woman was admitted to the hospital with worsening dyspnoea, cough and chest pain. This was on a background of weight loss, decreased appetite, mononeuritis multiplex, chronic eosinophilia and a single episode of a non-blanching rash. Investigations demonstrated a raised troponin and ischaemic changes on ECG, and she was therefore initially treated for a presumed myocardial infarction. However, her symptoms failed to improve with treatment for the acute coronary syndrome. A coronary angiogram revealed no significant flow-limiting disease, and further investigations yielded confirmation of raised eosinophils and a positive perinuclear antineutrophil cytoplasmic antibody test. An echocardiogram demonstrated a pericardial effusion, and subsequent cardiac magnetic resonance features were compatible with myopericarditis. In light of these findings, the patient was diagnosed with eosinophilic granulomatous with polyangiitis and commenced on high-dose intravenous methylprednisolone and cyclophosphamide. She made an excellent recovery and remains in remission on azathioprine and a tapering dose of corticosteroids.

  • pericardial disease
  • vasculitis
View Full Text

Statistics from Altmetric.com

Footnotes

  • Contributors All authors contributed substantially to the design of this work, the acquisition and interpretation of data, drafting of the manuscript and final approval of version to be submitted. MD: analysed and interpreted the data, and drafted the final manuscript. JN: analysed and interpreted the data, and edited and approved the final manuscript. RS: acquired the data, and edited and approved the final manuscript. PK: acquired, analysed and interpreted the data, analysed and collated the images, and edited and approved the final manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Patient consent for publication Obtained.

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.