Loffler's Endomyocardial Fibrosis, Eosinophilia, and Acute Lymphoblastic Leukemia

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Abstract
Eosinophilia is a constant feature of Loffler's endomyocardial fibrosis.1,2 Three cases of this syndrome have been described in which acute lymphoblastic leukemia was concurrently present.3,4 Cytogenetic evidence in one of these cases suggested that the eosinophilia was "reactive" because the eosinophils had a normal karyotype while the lymphoblasts showed chromosomal aneuploidy.4 The subject of eosinophilia and eosinophilic syndromes has been extensively reviewed by others.5-8 The purpose of this report is to describe a boy with long-standing eosinophilia who presented with intractable heart failure, striking peripheral blood eosinophilia, and 38% lymphoblasts in the bone marrow. Current thoughts concerning the relationship of endomyocardial fibrosis, acute lymphoblastic leukemia, and eosinophilia are summarized.

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