Hypereosinophilic syndrome- when to think of Loeffler`s endocarditis?

Abstract

Hypereosinophilic Syndrome (HES) is a rare and heterogeneous group of disorders defined as persistent circulating eosinophilia (> 1.5 × 109/L for more than six consecutive months) associated with signs and/or symptoms of organ damage in the absence of other objective causes of eosinophilia such as parasitic infections, allergic reactions, etc. Two forms of idiopathic HES are known: endomiocardial fibrosis (Darier`s disease) and  Loeffler`s endocarditis.  Loeffler`s  endocarditis (endomiocardial disease, eosinophilic disease) is characterized by hypereosinophilia in the blood and endocardium, leading to the development of restrictive cardiomyopathy with endocardial fibrous thickening in the apical and subclavian areas of the heart, for no recognizable reason. Heart involvement occurs in 60-75% of cases. Fibrosis increases cardiac rigidity, which leads to restrictive cardiomyopathy and the subsequent development of severe heart failure . The purpose of this literary review is to represent  the characteristic signs of Loeffler endocarditis in order to raise awareness and focus on rare myocardial  diseases. This would lead to a faster and more accurate diagnosis and start early treatment.