{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T21:22:05Z","timestamp":1769721725559,"version":"3.49.0"},"reference-count":8,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2025,3,21]],"date-time":"2025-03-21T00:00:00Z","timestamp":1742515200000},"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":[[2025,3,28]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Eosinophilic myocarditis is a rare condition that can be associated with hypersensitivity reactions. Endomyocardial biopsy (EMB) is required for diagnosis, especially when cardiac magnetic resonance (CMR) is inconclusive. Immunosuppressive treatment is usually limited to corticosteroids.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Case summary<\/jats:title>\n                  <jats:p>Two days following an inclisiran injection for dyslipidaemia management, a 72-year-old Caucasian male with a history of coronary artery disease experienced progressive shortness of breath. Suspecting a hypersensitivity reaction to inclisiran, corticosteroids were administered. After discontinuing corticosteroids, the patient experienced recurrent dyspnoea. Laboratory tests indicated eosinophilia, increased serum immunoglobulin E (IgE), and positive specific serum IgE for Aspergillus fumigatus. Imaging tests and a lung biopsy revealed pulmonary aspergillosis, while CMR showed myocardial inflammation. The patient was initially treated with itraconazole and steroid therapy. However, he was re-hospitalized for worsening of the cardiac and respiratory condition after tapering steroids. A diagnosis of severe eosinophilic asthma associated with allergic bronchopulmonary aspergillosis was established. L\u00f6ffler\u2019s endocarditis related to Aspergillus-induced eosinophilia was suspected and confirmed by repeated CMR and an EMB. Mepolizumab, an interleukin-5 (IL-5) inhibitor, was initiated resulting in symptom resolution and absence of inflammation at the 6-month follow-up CMR.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Discussion<\/jats:title>\n                  <jats:p>This case describes an uncommon response to inclisiran that resulted in Aspergillus-induced, steroid-dependent, eosinophilic systemic inflammation, resulting in severe asthma and endocarditis. It demonstrates how biological IL-5 inhibitors are effective in treating both components, emphasizing the necessity of a multidisciplinary strategy.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ehjcr\/ytaf127","type":"journal-article","created":{"date-parts":[[2025,3,16]],"date-time":"2025-03-16T12:11:47Z","timestamp":1742127107000},"source":"Crossref","is-referenced-by-count":3,"title":["Anti-interleukin-5 efficacy in an inclisiran-triggered eosinophilic myocarditis: a case report"],"prefix":"10.1093","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-9738-9225","authenticated-orcid":false,"given":"Francesco","family":"Tartaglia","sequence":"first","affiliation":[{"name":"Department of Biomedical Sciences, Humanitas University , Via Rita Levi Montalcini, 4, 20079 Pieve Emanuele-Milan , Italy"},{"name":"IRCCS Humanitas Research Hospital Cardiovascular Department, , Via Alessandro Manzoni, 56, 20089 Rozzano-Milan ,","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3999-3372","authenticated-orcid":false,"given":"Maria Rita","family":"Messina","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences, Humanitas University , Via Rita Levi Montalcini, 4, 20079 Pieve Emanuele-Milan , Italy"},{"name":"Personalized Medicine, Asthma and Allergy Department, IRCCS Humanitas Research Hospital , Rozzano ,","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefania","family":"Rizzo","sequence":"additional","affiliation":[{"name":"Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua , Via VIII Febbraio, 2, 35122 Padua ,","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Enrico","family":"Heffler","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences, Humanitas University , Via Rita Levi Montalcini, 4, 20079 Pieve Emanuele-Milan , Italy"},{"name":"Personalized Medicine, Asthma and Allergy Department, IRCCS Humanitas Research Hospital , Rozzano ,","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9198-3676","authenticated-orcid":false,"given":"Cristina","family":"Panico","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences, Humanitas University , Via Rita Levi Montalcini, 4, 20079 Pieve Emanuele-Milan , Italy"},{"name":"IRCCS Humanitas Research Hospital Cardiovascular Department, , Via Alessandro Manzoni, 56, 20089 Rozzano-Milan ,","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2025,3,21]]},"reference":[{"key":"2025041510351380200_ytaf127-B1","doi-asserted-by":"crossref","first-page":"2363","DOI":"10.1016\/j.jacc.2017.09.023","article-title":"Eosinophilic myocarditis","volume":"70","author":"Brambatti","year":"2017","journal-title":"J Am Coll Cardiol"},{"key":"2025041510351380200_ytaf127-B2","doi-asserted-by":"crossref","first-page":"ytac388","DOI":"10.1093\/ehjcr\/ytac388","article-title":"A case series of eosinophilic myocarditis: different faces of the same coin","volume":"6","author":"Mengesha","year":"2022","journal-title":"Eur Heart J Case Rep"},{"key":"2025041510351380200_ytaf127-B3","doi-asserted-by":"crossref","first-page":"82","DOI":"10.1161\/CIRCULATIONAHA.108.833566","article-title":"Images in cardiovascular medicine. Loeffler endocarditis mimicking apical hypertrophic cardiomyopathy","volume":"120","author":"Chang","year":"2009","journal-title":"Circulation"},{"key":"2025041510351380200_ytaf127-B4","doi-asserted-by":"crossref","first-page":"e007405","DOI":"10.1161\/CIRCHEARTFAILURE.120.007405","article-title":"Management of acute myocarditis and chronic inflammatory cardiomyopathy: an expert consensus document","volume":"13","author":"Ammirati","year":"2020","journal-title":"Circ Heart Fail"},{"key":"2025041510351380200_ytaf127-B5","doi-asserted-by":"crossref","first-page":"3503","DOI":"10.1093\/eurheartj\/ehad194","article-title":"2023 ESC guidelines for the management of cardiomyopathies","volume":"44","author":"Arbelo","year":"2023","journal-title":"Eur Heart J"},{"key":"2025041510351380200_ytaf127-B6","doi-asserted-by":"crossref","first-page":"799","DOI":"10.1183\/09031936.03.00027302","article-title":"Monoclonal anti-interleukin-5 treatment suppresses eosinophil but not T-cell functions","volume":"21","author":"B\u00fcttner","year":"2003","journal-title":"Eur Respir J"},{"key":"2025041510351380200_ytaf127-B7","doi-asserted-by":"crossref","first-page":"102267","DOI":"10.1016\/j.jaccas.2024.102267","article-title":"Interleukin-5 antagonist monoclonal antibody therapy improves symptoms and reduces steroid dependence in eosinophilic myocarditis patients","volume":"29","author":"Trovato","year":"2024","journal-title":"JACC Case Rep"},{"key":"2025041510351380200_ytaf127-B8","doi-asserted-by":"crossref","first-page":"bcr2016218992","DOI":"10.1136\/bcr-2016-218992","article-title":"Therapeutic effect of anti-IL-5 on eosinophilic myocarditis with large pericardial effusion","volume":"2017","author":"Song","year":"2017","journal-title":"BMJ 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\/ytaf127\/62495310\/ytaf127.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ehjcr\/article-pdf\/9\/4\/ytaf127\/62495310\/ytaf127.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ehjcr\/article-pdf\/9\/4\/ytaf127\/62495310\/ytaf127.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,15]],"date-time":"2025-04-15T10:35:32Z","timestamp":1744713332000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ehjcr\/article\/doi\/10.1093\/ehjcr\/ytaf127\/8088395"}},"subtitle":[],"editor":[{"given":"Valentina","family":"Rossi","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]},{"given":"Carlos Nicolas","family":"Perez-Garcia","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]},{"given":"Shahrukh","family":"Hashmani","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]},{"given":"Niklas","family":"Schenker","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2025,3,21]]},"references-count":8,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2025,3,28]]}},"URL":"https:\/\/doi.org\/10.1093\/ehjcr\/ytaf127","relation":{},"ISSN":["2514-2119"],"issn-type":[{"value":"2514-2119","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2025,4]]},"published":{"date-parts":[[2025,3,21]]},"article-number":"ytaf127"}}