The Leffler syndrome (W. Loffler)

Leffler syndrome

Leffler syndrome (W. Loffler) is a disease characterized by inflammatory infiltrates, rich in eosinophils, in the affected organs in combination with eosinophilia in the blood. In 1932, such an infiltrate was described in the lung, and later in other organs.

The true frequency of Leffler's syndrome is unknown, as it often remains unrecognized. Different types of Leffler syndrome are united by a similar etiology and pathogenesis. These are allergic diseases caused by different allergens. People with other allergic diseases are especially affected.

The conditions for the development of the Leffler syndrome in different organs are so dissimilar that their clinical pictures are very different. Almost completely harmless is the eosinophilic lung infiltrate (see). Favorably flowing and allergic eosinophilic pleurisy, independent or accompanying pneumonia.


There is a different picture of the Leffler syndrome in the cardiovascular system in all respects. It usually proceeds as a parietal fibroplastic endocarditis, affecting the endocardium of the ventricles, much less rarely endocardial atriums and not affecting the valves. Eosinophilic infiltrates, mainly located around small vessels, join the proliferation of collagen fibers of the endocardium and granulation of the basal layer of the endocardium and to the focalization of the ozomization of adjacent areas of the myocardium. Subsequent sclerosis of the endocardium, covering its thrombotic masses and myocardium leads to the creation of an internal cardiac heart and to a progressing heart failure without increasing the heart size. Detachment of infected or uninfected thrombus particles leads to embolisms, and vessel changes cause brain softening, severe nephritis, etc. Leffler's syndrome accompanies sometimes periarteritis nodosa.

Eosinophilic infiltrates can occur in all parts of the digestive tract. Joining the proliferation of collagen fibers submucosal, they are formed mainly around the blood vessels. So there is a narrowing of the lumen of the organ, leading to hypertrophy of the muscular layer of the overlying department and sometimes to the phenomena of obstruction. As a result, the x-ray and palpation picture of gastritis or enteritis simulates a malignant tumor and sometimes leads to an unnecessary operation.

Eosinophilic meningoencephalitis is acute, with severe eosinophilia in the blood and cerebrospinal fluid. With them, focal phenomena from the side of the brain are possible. The course is usually benign. As Leffler's syndrome of skin, liver, peritoneum, genital organs, as a rule, flows as well.

With all benign forms of Leffler syndrome, treatment is unnecessary. In protracted or more severe forms, various anti-inflammatory drugs (corticosteroids, calcium preparations), antihistamines (diphenhydramine, etc.) and desensitizing therapy are used. If possible, eliminate the acting allergen. Patients with parietal fibroplastic endocarditis are also given symptomatic drugs and anticoagulants.