PMC8110398_01
(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.
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An electrocardiogram (ECG) was normal (Figure 1(a)). Diffuse T-wave inversion appeared on serial ECGs, consistent with pericarditis (Figure 1(b)).
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.
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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.
The shift of the serum eosinophil count from admission to follow-up. Normal range: 0.04-0.19 K cells/microL.
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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.
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.
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Chest computed tomography revealed multiple pulmonary nodules with adjacent ground glass opacities, consistent with vasculitis or infection (Figure 4).