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Therapeutic effect of anti-IL-5 on eosinophilic myocarditis with large pericardial effusion
  1. Tengyao Song1,
  2. David Micheal Jones2,
  3. Yamen Homsi3
  1. 1Center for Molecular and Cellular Physiology, Albany Medical College, Albany, New York, USA
  2. 2Department of Pathology, Albany Medical Center, Albany, New York, USA
  3. 3Rheumatology, State University of New York Downstate Medical Center, Brooklyn, New York, USA
  1. Correspondence to Dr Yamen Homsi, Yamen.homsi{at}


Eosinophilic myocarditis (EM) is a rare myocardial disease that results from various eosinophilic diseases, such as idiopathic hypereosinophilic syndrome, helminth infection, medications and vasculitis. Patients with EM may present with different severities, ranging from mild symptoms to a life-threatening condition. Diagnosis of EM is a challenge and requires an extensive workup, including endomyocardial biopsy. Treatment options are limited because EM is rare and there is a lack of randomised controlled trials. We report a case of EM that presented as cardiac tamponade, which was initially treated with high-dose prednisone and immunosuppressant medications without significant improvement. Mepolizumab (anti-interleukin (IL)-5 antibody) was then applied, leading to an increased ejection fraction and stabilised cardiac function. This case report shows, for the first time, that mepolizumab has novel effects in treating EM. Our findings suggest that mepolizumab can be used as a steroid-sparing agent for treating EM.

  • Cardiovascular medicine
  • Immunology
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  • Contributors TS was involved in writing and editing of the case report. DMJ was involved in pathological study and providing images for the purpose of case report. YH was involved in direct patient care, data collection, and writing and editing of case report.

  • Competing interests None declared.

  • Patient consent Obtained.

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

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