Loeffler endocarditis presenting with large biventricular thrombi: a case report

Background: Loeffler endocarditis, a rare cardiac manifestation of hypereosinophilic syndrome (HES), results from chronic hypereosinophilia and associated tissue damage. Cardiac involvement in HES is linked to poor prognosis, especially in advanced stages. Due to its rarity outside tropical and subtropical regions, Loeffler endocarditis often poses a diagnostic challenge. Case Presentation: We report the case of a 28-year-old female with a history of asthma and idiopathic eosinophilia who presented with severe abdominal pain. She was initially misdiagnosed with cholecystitis. Subsequent investigations excluded secondary causes of eosinophilia, leading to the diagnosis of Loeffler endocarditis characterized by large biventricular thrombi. The patient was treated with high-dose corticosteroids. Discussion: This case highlights the importance of considering Loeffler endocarditis in patients presenting with compatible imaging and laboratory findings, even in regions where the condition is rare and often overlooked. Prompt recognition and diagnosis are crucial for initiating appropriate therapy and potentially improving outcomes in affected individuals.