STUDIES ON BLOOD EOSINOPHILS .2. PATIENTS WITH LOFFLERS CARDIOMYOPATHY

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  • 1 January 1976
    • journal article
    • research article
    • Vol. 24  (3) , 423-434
Abstract
Studies were done on blood eosinophils from 4 patients with raised blood eosinophil counts and heart failure. In 3 of the patients cardiological studies demonstrated the distinctive endocardial lesions and restrictive cardiomyopathy of Loeffler''s endocarditis and endomyocardial fibrosis. The 4th patient died with similar symptoms and signs. In blood films it was found that all 4 had more than 1 .times. 109 eosinophils/l which were vacuolated and contained reduced numbers of crystalloid granules which also had ultrastructural changes. Unlike eosinophils from normal individuals the patients'' eosinophils possessed receptors for rabbit IgG-coated erythrocytes and actively phagocytosed erythrocytes coated with rabbit IgG or human C3b. In these patients, a large proportion of the circulating eosinophils had developed characteristics of mature or stimulated eosinophils. This enabled them to respond to soluble substances in the bloodstream by forming endocytic vacuoles which led to degranulation of the crystalloid granules. The restrictive cardiomyopathy of hypereosinophilic states, including Loeffler''s endocarditis and endomyocardial fibrosis, is a result of prolonged release of products from degranulated eosinophils while they are in the circulation.