Eosinophil Granule Protein Localization in Eosinophilic Endomyocardial Disease

In this case report, eosinophilic endomyocardial disease was diagnosed in a patient on the basis of immunohistochemical evidence of eosinophil granule protein deposition in the heart, even in the absence of eosinophilic infiltration on cardiac biopsy. To the Editor: A 70-year-old man with chronic renal disease, splenomegaly, and eosinophilia presented with transient weakness in the left arm, visual disturbances, disequilibrium, and anomia. Magnetic resonance imaging of the brain showed findings consistent with numerous, small embolic strokes. Four echocardiograms, including a transesophageal echocardiogram, did not reveal abnormalities. Therapeutic trials of glucocorticoids and imatinib were unsuccessful at reducing the numbers of peripheral-blood eosinophils. To investigate the possibility that the emboli were the sequelae of eosinophilic endomyocardial disease, the patient underwent a biopsy of his right ventricle and intraventricular septum. Staining of the myocardium with hematoxylin and eosin did . . .