Loeffler’s Endocarditis- A cause of endomyocardial fibrosis in a patient of juvenile idiopathic arthritis: A Case Report

Authors

  • Taqdees Khaliq Federal Government Polyclinic Hospital, Islamabad, Pakistan
  • Sarah Azam Shah Federal Government Polyclinic Hospital, Islamabad, Pakistan
  • Saad Saleem Federal Government Polyclinic Hospital, Islamabad, Pakistan
  • Safina Hameed Qureshi Federal Government Polyclinic Hospital, Islamabad, Pakistan
  • Hamid Iqbal Federal Government Polyclinic Hospital, Islamabad, Pakistan
  • Fahad Khalid Federal Government Polyclinic Hospital, Islamabad, Pakistan

DOI:

https://doi.org/10.47391/JPMA.8648

Keywords:

Endomyocardial fibrosis, Juvenile Idiopathic Arthritis (JIA), TNF alpha inhibitors, Hyper-eosinophilic syndrome (HES)

Abstract

Endomyocardial fibrosis secondary to hyper-eosinophilic syndrome also known as Loeffler’s Endocarditis is a rare cause of restrictive cardiomyopathy. If left untreated, it carries a very high morbidity and mortality rate. The case of a 20 years old girl, a known case of polyarticular juvenile idiopathic arthritis since the age of 13 years was reported at Federal Government Polyclinic Hospital, Islamabad on 14th May 2022. She presented with an acute history of shortness of breath and cough for two weeks. Her initial echocardiogram showed suspicion of Loeffler’s Endocarditis, which is attributed to be an adverse effect of etanercept- a tumour necrosis factor (TNF) inhibitor, which she had been prescribed for her arthritis. The patient is currently being managed with high doses of steroids, therapeutic anticoagulation with rivaroxaban, carvedilol for tachycardia and mycophenolate mofetil as an immunosuppressant.

Key Words: Endomyocardial fibrosis, Juvenile Idiopathic Arthritis (JIA), TNF alpha inhibitors, Hyper-eosinophilic syndrome (HES).

Author Biographies

Sarah Azam Shah, Federal Government Polyclinic Hospital, Islamabad, Pakistan

Rheumatology department.

write up of the case report and part of the treating team

 

Saad Saleem, Federal Government Polyclinic Hospital, Islamabad, Pakistan

Rheumatology Department

Part of the treating team, referencing and write up 

Safina Hameed Qureshi, Federal Government Polyclinic Hospital, Islamabad, Pakistan

Rheumatology Department

Part of the treating team and Proof Reading.

Hamid Iqbal, Federal Government Polyclinic Hospital, Islamabad, Pakistan

Physician Cardiology .

part of treating team from cardiology side , helped in making the diagnosis.

 

Published

2024-03-20

How to Cite

Khaliq, T., Shah, S. A., Saleem, D. S. S., Qureshi, S. H., Iqbal, D. H. I., & Khalid, D. F. K. (2024). Loeffler’s Endocarditis- A cause of endomyocardial fibrosis in a patient of juvenile idiopathic arthritis: A Case Report. Journal of the Pakistan Medical Association, 74(4), 788–790. https://doi.org/10.47391/JPMA.8648

Issue

Section

Case Report