Löffler

Löffler's syndrome, also known as Löffler endocarditis, is a rare disease characterized by a type of inflammation of the endocardium (the inner layer of the heart's chambers) and is associated with eosinophilia—a higher than normal level of eosinophils in the blood. Eosinophils are a type of white blood cell that plays a role in the body's immune response, particularly in reactions to parasites and in allergic reactions. The condition is part of a spectrum of diseases caused by eosinophilic involvement of the heart, known as eosinophilic heart diseases.

Causes and Pathophysiology

Löffler's syndrome is primarily caused by a marked increase in eosinophils in the body, which can result from a variety of conditions, including parasitic infections, allergic reactions, and certain cancers. The exact mechanism by which eosinophils cause damage to the heart's endocardium in Löffler's syndrome is not fully understood. However, it is believed that the eosinophils release toxic substances that damage the heart tissue, leading to inflammation and eventually fibrosis (scarring).

Symptoms

The symptoms of Löffler's syndrome can vary widely depending on the extent of the heart involvement. Common symptoms include:

• Shortness of breath
• Fatigue
• Fever
• Weight loss
• Night sweats
• Cough
• Chest pain

In severe cases, Löffler's syndrome can lead to heart failure, characterized by the heart's inability to pump blood effectively.

Diagnosis

Diagnosis of Löffler's syndrome involves a combination of clinical evaluation, blood tests, imaging studies, and sometimes, a biopsy of the heart tissue. Blood tests typically show a high level of eosinophils. Imaging studies, such as echocardiography, can reveal abnormalities in the heart's structure and function that suggest Löffler's syndrome. In some cases, a cardiac MRI or a CT scan may also be used to provide more detailed images of the heart.

Treatment

Treatment of Löffler's syndrome focuses on addressing the underlying cause of the eosinophilia and managing the symptoms related to heart involvement. This may include:

• Medications to reduce eosinophil levels, such as corticosteroids
• Treatment of any underlying infections or cancers
• Medications to manage heart failure symptoms, if present

In advanced cases, where there is significant damage to the heart, surgical intervention may be necessary to repair or replace damaged heart valves.

Prognosis

The prognosis for individuals with Löffler's syndrome varies depending on the underlying cause of the eosinophilia and the extent of heart damage. Early diagnosis and treatment can improve outcomes, but severe cases involving extensive heart damage may have a poorer prognosis.

See Also

• Eosinophilia
• Endocarditis
• Heart failure