Löffler’s Endocarditis: First Report of Successful Mitral and Tricuspid Valve Replacements in a Patient with Long-Standing Hypereosinophilia
Bibliographic record
Abstract
Löffler’s endocarditis is a condition that occurs in patients with hypereosinophilic syndrome (HES). First described in 1975, HES is a relatively new syndrome that is characterized by elevated eosinophils with end organ damage. Hypereosinophilia is defined as elevated eosinophils of 1.5 x 109/L for at least one month, or tissue involvement as evidenced by bone marrow section with 20% eosinophils, tissue infiltration, and/or deposition of eosinophil granule proteins in tissue. Prevalence of HES in the United States is estimated to be 0.36–6.3/ 100,000 people, of which Löffler’s endocarditis represents only a fraction of cases. We present a case where a patient presented with palpitations and shortness of breath, with a background of chronically elevated eosinophils. HES was previously diagnosed in this patient due to persistently elevated eosinophils with lung damage (Löffler’s syndrome). On biopsy, she was found to have endomyocardial fibrosis with a thickened endocardium secondary to eosinophils. Echocardiogram showed moderate to severe regurgitation in both mitral and tricuspid valves due to regurgitation secondary to fibrosis. She subsequently underwent a successful dual valve replacement. This is the first case, to our knowledge, where a dual valve replacement was performed successfully in a patient with Löffler’s endocarditis.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.003 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.001 | 0.002 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.004 | 0.003 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".