Multiple microembolic borderzone brain infarctions and endomyocardial fibrosis in idiopathic hypereosinophilic syndrome and in Schistosoma mansoni infestation
- 1Department of Psychogeriatrics, Bretonneau Hospital, Paris, France
- 2Department of Infectious Diseases and Tropical Medicine, La Salpetriere Hospital, Paris, France
- 3Department of Cardiology, Saint-Antoine Hospital, Paris, France
- 4Department of Neurology and Stroke Centre, Bichat Hospital, Paris, France
- Correspondence to: Professor P Amarenco Department of Neurology and Stroke Centre, Bichat Hospital, 46 rue Henri Huchard, 75018 Paris, France; pierre.amarencobch.ap-hop-paris.fr
- Received 6 January 2003
- Accepted 9 May 2003
- Revised 9 May 2003
Abstract
We report two cases of multiple distal borderzone ischaemic strokes associated with hypereosinophilia due to idiopathic hypereosinophilic syndrome in one patient and to acute Schistosoma mansoni infestation in the other. Endomyocardial fibrosis (EMF) was documented pathologically, in one case at autopsy and in the other after cardiac surgery; and by cardiac CT, with initially negative echocardiography, in one patient. These observations suggest that so called borderzone infarcts may be due to microembolisms and that, in the context of hypereosinophilia, EMF diagnosis warrants complete cardiac investigation including cardiac CT and repeat echocardiography.
- EMF, endomyocardial fibrosis
- IHS, idiopathic hypereosinophilic syndrome
- TTE, transthoracic echocardiography
