Journal of Forensic and Legal Medicine
Volume 17, Issue 2 , Pages 57-61 , February 2010

Fatal carbamazepine induced fulminant eosinophilic (hypersensitivity) myocarditis: Emphasis on anatomical and histological characteristics, mechanisms and genetics of drug hypersensitivity and differential diagnosis

  • Nebojsa Arsenovic, MD SpecPath (Doctor)

      Affiliations

    • Cellular Pathology Department, PathLinks Pathology Services, Lincoln County Hospital, Greetwell Road, Lincoln LN2 5QY, UK
    • Corresponding Author InformationCorresponding author. Tel.: +44 1522573751.
  • ,
  • Loraine Sheehan, MBBS FRCPath (Doctor)

      Affiliations

    • Cellular Pathology Department, PathLinks Pathology Services, Lincoln County Hospital, Greetwell Road, Lincoln LN2 5QY, UK
  • ,
  • David Clark, MD FRCPath (Doctor)

      Affiliations

    • Cellular Pathology Department, PathLinks Pathology Services, Lincoln County Hospital, Greetwell Road, Lincoln LN2 5QY, UK
  • ,
  • Ricardo Moreira, BSc

      Affiliations

    • Department of Biomedical and Forensic Sciences, University of Lincoln, Brayford Pool, Lincoln LN6 7TS, UK

Received 15 March 2009 ,Revised 7 July 2009 ,Accepted 19 July 2009.

References 

  1. Bohn D, Benson L. Diagnosis and management of pediatric myocarditis. Paediatr Drugs. 2002;4:171–181
  2. O’Connell JB. Diagnosis and medical treatment of inflammatory cardiomyopathy. In:  Topol E,  Nissen J editor. Cardiovascular medicine. Philadelphia: Lippincott-Raven; 1998;p. 100
  3. Feldman AM, McNamara D. Myocarditis. New Engl J Med. 2000;19:1388–1398
  4. Walsh TJ, Hutchins GM, Bulkley BH, et al. Fungal infection of the heart: analysis of 51 autopsy cases. Am J Cardiol. 1980;45:357
  5. Albani F, Riva R, Baruzzi A. Carbamazepine clinical pharmacology: a review. Pharmacopsychiatria. 1995;235–244
  6. Durelli L, Massazza L, Cavallo R. Carbamazepine toxicity and poisoning. Incidence, clinical features and management. Med Toxicol Adv Drug Exp. 1989;95–107
  7. Fenoglio JF, Silver MD. Effects of drugs on the cardiovascular system. In:  Silver MD editors. Cardiovascular pathology. New York: Churchill Livingstone; 1991;
  8. Burke AP, et al. Hypersensitivity myocarditis. Arch Pathol Lab Med. 1991;115(8):764–769
  9. Bell MD, et al. Hypersensitivity myocarditis, drug-related. In:  Bloom S,  Lie JT,  Silver MD editor. Diagnostic criteria for cardiovascular pathology. Philadelphia (PA): Lippincott-Raven; 1997;
  10. Winters G, McManus BM. Myocarditis. In:  Silver MD,  Gotlieb AI,  Schoen FJ editor. Cardiovascular pathology. Livingstone: Churchill; 2001;
  11. Aggarwal A, et al. Hypersensitivity myocarditis presenting as cardiogenic shock. J Heart Lung Transpl. 2001;20(11):1241–1244
  12. Nozomi W, et al. Acute necrotizing eosinophilic myocarditis successfully treated by high dose methyl prednisolon. Jpn Circ J. 2001;65:923–926
  13. Virmani R, Atkinson JB. Endomyocardial biopsy in the diagnosis of heart diseases. In:  Virmani R,  Atkinson JB,  Fenoglio JF editor. Cardiovascular pathology. Philadelphia (PA): Saunders Company; 1991;p. 220–245
  14. Dilber E, et al. Acute myocarditis associated with tetanus vaccination. Mayo Clin Proc. 2003;78(11):1431–1433
  15. Zaacks SM, et al. Hypersensitivity myocarditis associated with ephedra use. J Toxicol Clin Toxicol. 1999;37(4):485–489
  16. Pieroni M, et al. Clozapine-induced hypersensitivity myocarditis. Chest. 2004;126(5):1703–1705
  17. Johnson MR, et al. Eosinophilic myocarditis in the explanted hearts of cardiac transplant recipients: interesting pathologic finding or pathophysiologic entity of clinical significance. Crit Care Med. 2004;32(3):888–900
  18. Takkenberg JJ, et al. Eosinophilic myocarditis in patients awaiting heart transplantation. Crit Care Med. 2004;32(3):714–721
  19. Gerber BO, Pichler WJ. Cellular mechanisms of T cell mediated drug hypersensitivity. Curr Opin Immunol. 2004;16(6):732–737
  20. Gleich GJ. Mechanisms of eosinophil-associated inflammation. J Allergy Clin Immunol. 2000;105(4):651–663
  21. Pichler WJ. Immune mechanism of drug hypersensitivity. Immunol Allergy Clin North Am. 2004;24(3):373–397
  22. Pichler WJ. Pharmacological interaction of drugs with antigen-specific immune receptors: the p-i concept. Curr Opin Allergy Clin Immunol. 2002;2(4):301–305
  23. Mallal S, et al. Association between presence of HLA-B*5701, HLA-DR7, and HLA-DQ3 and hypersensitivity to HIV-1 reverse-transcriptase inhibitor abacavir. Lancet. 2002;359(9308):727–732
  24. Chung WH, et al. Medical genetics: a marker for Stevens–Johnson syndrome. Nature. 2004;428(6982):486
  25. Hung SI, et al. HLA-B*5801 allele as a genetic marker for severe cutaneous adverse reactions caused by allopurinol. Proc Natl Acad Sci USA. 2005;102(11):4134–4139
  26. Martin AM, et al. Predisposition to nevirapine hypersensitivity associated with HLA-DRB1*0101 and abrogated by low CD4 T-cell counts. AIDS. 2005;19(1):97–99
  27. Chusid MJ, Dale DC, West BC, Wolff SM. The hypereosinophilic syndrome: analysis of fourteen cases with review of the literature. Medicine (Baltimore). 1975;54(1):1–27
  28. Simon HU, Plötz SG, Dummer R, Blaser K. Abnormal clones of T cells producing interleukin-5 in idiopathic eosinophilia. New Engl J Med. 1999;341(15):1112–1120
  29. Grabellus F, et al. Immnuohistochemical differentiation of eosinophilic heart disease using antibodies against eosinophil activation markers. Histopathology. 2005;46:89–97
  30. Kodama M, Matsumoto Y, Fujiwara M, Masani F, Izumi T, Shibata A. A novel experimental model of giant cell myocarditis induced in rats by immunization with cardiac myosin fraction. Clin Immunol Immunopathol. 1990;57:250–262
  31. Mone SM, Sanders SP, Colan SD. Control mechanisms for physiological hypertrophy of pregnancy. Circulation. 1996;94(4):667–672
  32. Wagner BM. Left ventricular hypertrophy and sudden death. Hum Pathol. 1986;17:1
  33. Dominick J Di Maio, Vincent JM Di Maio. Forensic pathology. 2nd ed.. Florida: CRC Press; 2001;
  34. Salzman MB, Valderrama E, Sood SK. Carbamazepine and fatal eosinophilic myocarditis. New Engl J Med. 1997;336(12):878–879

PII: S1752-928X(09)00125-5

doi: 10.1016/j.jflm.2009.07.021

Journal of Forensic and Legal Medicine
Volume 17, Issue 2 , Pages 57-61 , February 2010