{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,30]],"date-time":"2025-11-30T22:50:12Z","timestamp":1764543012764,"version":"3.41.2"},"reference-count":18,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2025,1,17]],"date-time":"2025-01-17T00:00:00Z","timestamp":1737072000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,2,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Eosinophilic granulomatosis with polyangiitis (EGPA) is a systemic vasculitis that affects small-to-medium vessels of various organs and can lead to eosinophilic myocarditis, a rare but life-threatening condition. The diagnosis of EGPA is challenging due to overlapping features with other forms of vasculitis. Additionally, various clinical presentations of EGPA make its management complicated.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Case summary<\/jats:title>\n                  <jats:p>A 55-year-old man with a history of asthma presented with worsening chest pain. Peripheral hyper-eosinophilia, elevated troponin level, refractory pulseless ventricular tachycardia, and severe cardiac dysfunction suggested fulminant eosinophilic myocarditis. A multidisciplinary team comprising rheumatology, respirology, haematology, pathology, and cardiology specialists discussed the underlying cause of eosinophilia and diagnosed EGPA with the pathological findings of endomyocardial biopsy (EMB). Immunosuppressive therapy and optimal medical therapy for acute heart failure resulted in remission of myocarditis, as confirmed by follow-up echocardiography, cardiac magnetic resonance imaging, and EMB. Despite a good clinical course, mononeuritis rapidly worsened just before his discharge, requiring additional therapy. During the 2-year outpatient follow-up, the cardiac function remains well, and mononeuritis also improved.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Discussion<\/jats:title>\n                  <jats:p>The multidisciplinary approach facilitated prompt and accurate diagnosis and treatment, despite the disease\u2019s diverse presentation, ultimately saving the patient\u2019s life. This case highlights the importance of systemic evaluations in patients with EGPA, potentially affecting multiple organs, for monitoring disease status and guiding its treatment. This case report also emphasizes that close follow-up and careful monitoring with cardiac multimodality imaging are important to ensure optimal management of heart failure caused by EGPA myocarditis.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ehjcr\/ytaf010","type":"journal-article","created":{"date-parts":[[2025,1,17]],"date-time":"2025-01-17T06:39:18Z","timestamp":1737095958000},"source":"Crossref","is-referenced-by-count":1,"title":["Acute heart failure due to fulminant eosinophilic myocarditis with mononeuritis: eosinophilic granulomatosis with polyangiitis requiring cardiac multimodality imaging and systemic evaluation: a case report"],"prefix":"10.1093","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0261-9328","authenticated-orcid":false,"given":"Jun-ichi","family":"Noiri","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Medicine, Yodogawa Christian Hospital , 1-7-50 Kunijima, Higashi Yodogawa, 533-0024 Osaka ,","place":["Japan"]},{"name":"Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine , 7-5-1 Kusunoki, Chuo, 650-0017 Kobe ,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9180-1334","authenticated-orcid":false,"given":"Hiroki","family":"Matsuzoe","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Yodogawa Christian Hospital , 1-7-50 Kunijima, Higashi Yodogawa, 533-0024 Osaka ,","place":["Japan"]},{"name":"Division of Cardiology, Kindai University Faculty of Medicine , 377-2 Onohigashi, Osakasayama, 589-8511 Osaka ,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3542-6661","authenticated-orcid":false,"given":"Ryo","family":"Nishio","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Yodogawa Christian Hospital , 1-7-50 Kunijima, Higashi Yodogawa, 533-0024 Osaka ,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Youhei","family":"Fujiki","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, Yodogawa Christian Hospital , 1-7-50 Kunijima, Higashi Yodogawa, 533-0024 Osaka ,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kenichiro","family":"Otani","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, Yodogawa Christian Hospital , 1-7-50 Kunijima, Higashi Yodogawa, 533-0024 Osaka ,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mayumi","family":"Inaba","sequence":"additional","affiliation":[{"name":"Department of Pathology, Yodogawa Christian Hospital , 1-7-50 Kunijima, Higashi Yodogawa, 533-0024 Osaka ,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiroshi","family":"Takaishi","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Yodogawa Christian Hospital , 1-7-50 Kunijima, Higashi Yodogawa, 533-0024 Osaka ,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1642-7039","authenticated-orcid":false,"given":"Hidekazu","family":"Tanaka","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine , 7-5-1 Kusunoki, Chuo, 650-0017 Kobe ,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2025,1,17]]},"reference":[{"key":"2025020715453563500_ytaf010-B1","doi-asserted-by":"crossref","first-page":"1088","DOI":"10.1002\/acr.24634","article-title":"2021 American College of Rheumatology\/Vasculitis Foundation guideline for the management of antineutrophil cytoplasmic antibody-associated vasculitis","volume":"73","author":"Chung","year":"2021","journal-title":"Arthritis Care Res (Hoboken)"},{"key":"2025020715453563500_ytaf010-B2","doi-asserted-by":"crossref","first-page":"236","DOI":"10.1097\/MD.0b013e3181af35a5","article-title":"Cardiac involvement in Churg\u2013Strauss syndrome: impact of endomyocarditis","volume":"88","author":"Neumann","year":"2009","journal-title":"Medicine (Baltimore)"},{"key":"2025020715453563500_ytaf010-B3","doi-asserted-by":"crossref","first-page":"2107","DOI":"10.1002\/ehf2.14244","article-title":"Churg\u2013Strauss syndrome-associated heart failure and left ventricular thrombosis","volume":"10","author":"Liori","year":"2023","journal-title":"ESC Heart Fail"},{"key":"2025020715453563500_ytaf010-B4","doi-asserted-by":"crossref","first-page":"709","DOI":"10.1002\/ehf2.14172","article-title":"What\u2019s behind your eosinophilic myocarditis? A case of Churg\u2013Strauss syndrome diagnosed during acute heart failure","volume":"10","author":"Amelotti","year":"2023","journal-title":"ESC Heart Fail"},{"key":"2025020715453563500_ytaf010-B5","doi-asserted-by":"crossref","first-page":"2363","DOI":"10.1016\/j.jacc.2017.09.023","article-title":"Eosinophilic myocarditis: characteristics, treatment, and outcomes","volume":"70","author":"Brambatti","year":"2017","journal-title":"J Am Coll Cardiol"},{"key":"2025020715453563500_ytaf010-B6","doi-asserted-by":"crossref","first-page":"309","DOI":"10.1136\/annrheumdis-2021-221794","article-title":"2022 American College of Rheumatology\/European Alliance of Associations for Rheumatology Classification Criteria for Eosinophilic Granulomatosis with Polyangiitis","volume":"81","author":"Grayson","year":"2022","journal-title":"Ann Rheum Dis"},{"key":"2025020715453563500_ytaf010-B7","doi-asserted-by":"crossref","first-page":"378","DOI":"10.1038\/s41584-023-00958-w","article-title":"Evidence-based guideline for the diagnosis and management of eosinophilic granulomatosis with polyangiitis","volume":"19","author":"Emmi","year":"2023","journal-title":"Nat Rev Rheumatol"},{"key":"2025020715453563500_ytaf010-B8","doi-asserted-by":"crossref","first-page":"270","DOI":"10.1002\/art.37721","article-title":"Eosinophilic granulomatosis with polyangiitis (Churg\u2013Strauss): clinical characteristics and long-term followup of the 383 patients enrolled in the French Vasculitis Study Group cohort","volume":"65","author":"Comarmond","year":"2013","journal-title":"Arthritis Rheum"},{"key":"2025020715453563500_ytaf010-B9","doi-asserted-by":"crossref","first-page":"1921","DOI":"10.1056\/NEJMoa1702079","article-title":"Mepolizumab or placebo for eosinophilic granulomatosis with polyangiitis","volume":"376","author":"Wechsler","year":"2017","journal-title":"N Engl J Med"},{"key":"2025020715453563500_ytaf010-B10","doi-asserted-by":"crossref","first-page":"387","DOI":"10.1093\/mr\/roab005","article-title":"Low-dose mepolizumab is effective as an add-on therapy for treating long-lasting peripheral neuropathy in patients with eosinophilic granulomatosis with polyangiitis","volume":"32","author":"Nakamura","year":"2022","journal-title":"Mod Rheumatol"},{"key":"2025020715453563500_ytaf010-B11","doi-asserted-by":"crossref","first-page":"1206","DOI":"10.3899\/jrheum.161436","article-title":"Longterm prognosis of 121 patients with eosinophilic granulomatosis with polyangiitis in Japan","volume":"44","author":"Tsurikisawa","year":"2017","journal-title":"J Rheumatol"},{"key":"2025020715453563500_ytaf010-B12","doi-asserted-by":"crossref","first-page":"768","DOI":"10.1136\/annrheumdis-2021-221733","article-title":"EULAR recommendations for cardiovascular risk management in rheumatic and musculoskeletal diseases, including systemic lupus erythematosus and antiphospholipid syndrome","volume":"81","author":"Drosos","year":"2022","journal-title":"Ann Rheum Dis"},{"key":"2025020715453563500_ytaf010-B13","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1016\/j.ejim.2016.09.014","article-title":"Comprehensive evaluation of cardiac involvement in eosinophilic granulomatosis with polyangiitis (EGPA) with cardiac magnetic resonance","volume":"39","author":"Cereda","year":"2017","journal-title":"Eur J Intern Med"},{"key":"2025020715453563500_ytaf010-B14","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1016\/j.ejim.2020.12.008","article-title":"Cardiac involvement in eosinophilic granulomatosis with polyangiitis (formerly Churg\u2013Strauss syndrome): prospective evaluation at a tertiary referral centre","volume":"85","author":"Zampieri","year":"2021","journal-title":"Eur J Intern Med"},{"key":"2025020715453563500_ytaf010-B15","doi-asserted-by":"crossref","first-page":"3627","DOI":"10.1093\/eurheartj\/ehad195","article-title":"2023 Focused Update of the 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: developed by the task force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC) with the special contribution of the Heart Failure Association (HFA) of the ESC.","volume":"44","author":"McDonagh","year":"2023","journal-title":"Eur Heart J"},{"key":"2025020715453563500_ytaf010-B16","doi-asserted-by":"crossref","first-page":"1755","DOI":"10.1002\/ejhf.2947","article-title":"Global longitudinal strain predicts clinical outcomes in patients with heart failure with preserved ejection fraction","volume":"25","author":"Brann","year":"2023","journal-title":"Eur J Heart Fail"},{"key":"2025020715453563500_ytaf010-B17","doi-asserted-by":"crossref","first-page":"2649","DOI":"10.1093\/eurheartj\/ehx321","article-title":"Diagnosis and management of myocardial involvement in systemic immune-mediated diseases: a position statement of the European Society of Cardiology Working Group on Myocardial and Pericardial Disease","volume":"38","author":"Caforio","year":"2017","journal-title":"Eur Heart J"},{"key":"2025020715453563500_ytaf010-B18","doi-asserted-by":"crossref","first-page":"ytab399","DOI":"10.1093\/ehjcr\/ytab399","article-title":"Eosinophilic perimyocarditis associated with eosinophilic granulomatosis with polyangiitis: a case report","volume":"5","author":"Blumetti","year":"2021","journal-title":"Eur Heart J Case Rep"}],"container-title":["European Heart Journal - Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ehjcr\/advance-article-pdf\/doi\/10.1093\/ehjcr\/ytaf010\/61474809\/ytaf010.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ehjcr\/article-pdf\/9\/2\/ytaf010\/61474809\/ytaf010.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ehjcr\/article-pdf\/9\/2\/ytaf010\/61474809\/ytaf010.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,2,7]],"date-time":"2025-02-07T15:45:58Z","timestamp":1738943158000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ehjcr\/article\/doi\/10.1093\/ehjcr\/ytaf010\/7959065"}},"subtitle":[],"editor":[{"given":"Giulia Elena","family":"Mandoli","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]},{"given":"Vincenzo","family":"Nuzzi","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]},{"given":"Duygu","family":"Kocyigit Burunkaya","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]},{"given":"Sumit","family":"Sohal","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]},{"given":"Sibghat","family":"Tul Llah","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2025,1,17]]},"references-count":18,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2025,2,1]]}},"URL":"https:\/\/doi.org\/10.1093\/ehjcr\/ytaf010","relation":{},"ISSN":["2514-2119"],"issn-type":[{"type":"electronic","value":"2514-2119"}],"subject":[],"published-other":{"date-parts":[[2025,2]]},"published":{"date-parts":[[2025,1,17]]},"article-number":"ytaf010"}}