case_images: PMC8110398_01
case_images: (a) The ECG was obtained on admission and shows a normal repolarization pattern. (b) The ECG represents the follow-up ECG at two weeks after presentation and shows diffuse T-wave inversion.
case_images: CRIPE2021-5526968.001.jpg
case_images: PMC8110398_01_CRIPE2021-5526968.001.jpg
case_images: fig1
case_images: An electrocardiogram (ECG) was normal (Figure 1(a)). Diffuse T-wave inversion appeared on serial ECGs, consistent with pericarditis (Figure 1(b)).
case_images: Cardiac MRI, cine short-axis (a) and 4-chamber (b) views showing a moderate-sized pericardial effusion. (c) Short-axis T2 map showing myocardial T2 is elevated (70 ms) consistent with diffuse edema.
case_images: CRIPE2021-5526968.002.jpg
case_images: PMC8110398_01_CRIPE2021-5526968.002.jpg
case_images: fig2
case_images: T of 0.25 ng/mL (normal <0.1 ng/mL). CMR (Figure 2) showed an elevated myocardial global T2 value (70 ms), an elevated native myocardial global T1 value (1150 ms), increased left ventricular wall thickness, and a moderate-sized pericardial effusion. There was no myocardial late gadolinium enhancement.
case_images: The shift of the serum eosinophil count from admission to follow-up. Normal range: 0.04-0.19 K cells/microL.
case_images: CRIPE2021-5526968.003.jpg
case_images: PMC8110398_01_CRIPE2021-5526968.003.jpg
case_images: fig3
case_images: However, the peripheral eosinophilia increased (Figure 3). At late follow-up there was a normal eosinophil count (Figure 3), and on echocardiogram, there was normal ventricular function and no pericardial effusion.
case_images: Axial CT images with contrast showing (a) large pericardial effusion and (b) calcified, but not enlarged right lower paratracheal region mediastinal nodes. (c) A 10 mm nodule at the right hilar region that has a mild spiculated appearance with adjacent ground glass opacities suggestive of hilar adenopathy versus pulmonary nodule. (d) Additional pulmonary nodule.
case_images: CRIPE2021-5526968.004.jpg
case_images: PMC8110398_01_CRIPE2021-5526968.004.jpg
case_images: fig4
case_images: Chest computed tomography revealed multiple pulmonary nodules with adjacent ground glass opacities, consistent with vasculitis or infection (Figure 4).