Korean Circ J.  2008 Aug;38(8):436-439. 10.4070/kcj.2008.38.8.436.

A Case of Hypereosinophilic Syndrome Presenting as Pericardial Effusion, Myocarditis and Ascites

  • 1Department of Internal Medicine, Soonchunghyang University Cheonan Hospital, Cheonan, Korea. matsalong@schch.co.kr


Hypereosinophilic syndrome is a clinical disorder characterized by peripheral eosinophilia and eosinophilic infiltration of multiple organ systems, including the cardiovascular system. The manifestations are variable, but cardiac involvement is the major source of morbidity and mortality, and several case reports have highlighted the various types of cardiac involvement. However, no reported case has simultaneously presented with pericardial effusion, myocarditis, and ascites. We report a case of a 28-year-old woman with hypereosinophilic syndrome involving both the heart and intra-abdominopelvic cavity.


Hypereosinophilic syndrome; Myocarditis; Ascites

MeSH Terms

Cardiovascular System
Hypereosinophilic Syndrome
Pericardial Effusion


  • Fig. 1 Initial images. A: chest X-ray demonstrated cardiomegaly and bilateral pleural effusions. B: chest CT demonstrated pericardial effusion and bilateral pleural effusions. C: abdominal CT demonstrated ascites in the gallbladder fossa. D: pelvic CT demonstrated ascites in the pelvic cavity.

  • Fig. 2 Echocardiographic findings. A: 2D echocardiography (parasternal long axis view) demonstrated multiple regional wall motion abnormalities incompatible with the coronary territory, a moderate pericardial effusion of no hemodynamic significance, and increased thickening of the basal inferoposterior wall. B: M-mode echocardiography demonstrated a regional wall motion abnormality of the basal inferoposterior wall. There was mild left ventricular dysfunction (ejection fraction-45%), but no systolic wall thickening.

  • Fig. 3 Endomyocardial biopsy revealed a markedly increased number of eosinophils infiltrating the endomyocardial tissue. A: H & E stain, ×100. B: H & E stain, ×400. H & E: hematoxylin and eosin.

  • Fig. 4 Follow-up images. A: chest X-ray showed no cardiomegaly or pleural effusion. B: echocardiography showed that the pericardial effusion and abnormal echogenicity of the posterolateral wall had resolved. C, D: abdominal CT demonstrated marked improvement of ascites in the gallbladder fossa and pelvic cavity.


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