Cardiac involvement mimicking acute coronary syndrome in idiopathic hypereosinophilic syndrome.

Hypereosinophilic syndrome (HES) is defined as a persistent eosinophilia lasting longer than 6 months of unknown origin and related to organ involvement. Cardiac involvement, usually leading to morbidity and mortality of HES patients, often mimics other diseases such as acute coronary syndrome. We report a 46-year-old female who came to hospital with atypical chest pains and a known history of eosinophilia. After excluding other possible causes of eosinophilia, she underwent further cardiac investigations. She had normal cardiac size on echocardiography and no thrombus or mass, with only global hypokinesia with systolic and diastolic dysfunction noted. These findings were different from other studies. This patient was then treated as HES with cardiac involvement.

The correlation between CD4+ T-lymphocyte count and tuberculosis form in TB-HIV coinfected patients in Indonesia.

AIM: to find whether there is a correlation between CD4+ count and TB form in TB-HIV Coinfected patients in Indonesia. METHODS: this is a cross-sectional study of the TB-HIV patients at National HIV Center POKDISUS, Cipto Mangunkusumo Hospital in 2008-2011. We classified TB form as pulmonary TB, extrapulmonary TB, milliary TB, and combination form. The data were analyzed by Spearman and lambda correlation test. We also did partial correlation test to eliminate some counfounding factors, including demography and clinical characteristics, that had been determinated before. RESULTS: there were 122 TB-HIV patients (aged median 31 [18-34], 80% male) included in this study. The most common TB form was pulmonary TB (71.2%), then extrapulmonary TB (7.4%), the combined type (18.9%), and milliary TB (2.5%). Median of CD4+ count was 40 cells/mL (IQR 17.5-100.6). There was a very weak correlation between CD4+ count and TB form in TB-HIV patients in Indonesia (r=0.185; p=0.042). The other factor that also showed a significant correlation to TB form is HIV staging (r=0.289; p=0.001). After adjusting those factors, we found an increase on correlation between CD4+ count and TB form (r=0.353; p=0.000). CONCLUSION: there was a correlation between CD4+ count and TB form in TB-HIV patients in Indonesia, but in a very weak correlation.