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American Journal of Case Reports is ranked the World leading among journals dedicated to publishing clinical case reports. AJCR is indexed in Web of Science, PubMed/ PMC, Scopus

(1) CiteScore (Impact Factor - like by Scopus, Elsevier) is the number of citations received by a journal in one year to documents published in the three previous years, divided by the number of documents indexed in Scopus published in those same three years.

(2) SNIP (Source Normalized Impact per Paper) measures a source’s contextual citation impact by weighting citations based on the total number of citations in a subject field. It helps you make a direct comparison of sources in different subject fields. SNIP takes into account the characteristics of the source's subject field, which is the set of documents citing that source.

(3) SJR is weighted by the prestige of a journal. Subject field, quality, and reputation of the journal have a direct effect on the value of a citation. SJR assigns relative scores to all of the sources in a citation network. Its methodology is inspired by the Google PageRank algorithm, in that not all citations are equal. A source transfers its own 'prestige', or status, to another source through the act of citing it. A citation from a source with a relatively high SJR is worth more than a citation from a source with a lower SJR. 

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Clinical case reports are an invaluable first-hand source of evidence in medicine and a tool most often used in practice to exchange information and generate a more expanded search for evidence. In addition to the “evidence of what happened”, single or multiple cases are an important basis for further and more advanced research on diagnosis, treatment effectiveness, causes and outcomes of disease. However limited their conclusions may be, case reports remain a fundamental component of medicine, contributing greatly to the advancement of health care. In today's ever-expanding Evidence-Based Medicine, case reporting require a well-defined focus, content, and structure.

Presently, only a fraction of case reports is useful for clinical decision-making and bedside-decision oriented research. Therefore, the aim of the Journal is to gather case reports across medical disciplines, thereby integrating interdisciplinary, international medical knowledge.


Published: 2019-03-23

Idiopathic Hypereosinophilic Syndrome in an Elderly Female: A Case Report

Faiza Khalid, Fernando Holguin

(Department of Internal Medicine, University Hospital Cleveland Medical Center/Case Western Reserve University, Cleveland, USA)

Am J Case Rep 2019; 20:381-384

DOI: 10.12659/AJCR.912747


BACKGROUND: Hypereosinophilic syndrome (HES) is defined as hypereosinophilia with eosinophil mediated organ damage or dysfunction, provided that other causes of organ damage have been excluded.
CASE REPORT: An 83-year-old female presented with worsening dyspnea for 3 weeks. She was initially diagnosed with bronchitis and prescribed oral antibiotics along with prednisone taper. However, her dyspnea continued to worsen requiring hospitalization. Physical examination was significant for signs of volume overload. Laboratory investigations were notable for leukocytosis with eosinophilia, elevated BNP (brain natriuretic peptide) and troponin. Electrocardiogram (ECG) showed normal sinus rhythm with non-specific ST-T wave changes. Computed tomography (CT) scan of the chest showed pulmonary edema, bilateral peripheral ground glass opacities, and pleural effusions. Transthoracic echocardiogram (TTE) revealed an ejection fraction (EF) of 45%. She was diagnosed with NSTEMI (non-ST-elevation myocardial infarction) with new onset heart failure; appropriate management was initiated. Left heart catheterization did not show any significant obstructive lesions. Presence of peripheral ground glass opacities on the CT chest scan and eosinophilia raised suspicion for HES. Thorough HES workup was done, all tests came back negative except for elevated serum IgE level. Cardiac biopsy returned positive for eosinophilic myocarditis. Bone marrow biopsy showed 20% eosinophils. Positron emission tomography (PET) scan did not show any hypermetabolic lesions to suggest malignancy. The patient was managed for idiopathic HES with high dose steroids resulting in significant clinical improvement.
CONCLUSIONS: About 40% of patient with HES manifest cardiac involvement, and one quarter of patients with HES have pulmonary involvement with variable radiologic findings. Steroids remain the mainstay treatment for idiopathic HES.

Keywords: Disease Management, Hypereosinophilic Syndrome, myocarditis



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