Takotsubo cardiomyopathy associated with autoimmune polyendocrine syndrome II

Lim, Tingsong; Murakami, Hironori; Hayashi, Kentarō; Watanabe, Hiroki; Sasaki, Hayato; Muto, Harutatsu; Asano, Yosuke; Miyamoto, Kenjiro; Omoto, Yasuhiro; Yamaguchi, Y; Hirokami, Mitsugu; Tanaka, Shigemichi

doi:10.1016/j.jjcc.2008.08.005

Cited by 14 publications

(7 citation statements)

References 20 publications

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“…Myocardial systolic dysfunction has been reported to be reversible in most cases reported in the literature. Left ventricular systolic dysfunction was reported to manifest as apical ballooning (Takotsubo cardiomyopathy, TC) in one case (3) in which the patient was observed to have STsegment elevation and elevated levels of myocardial necrosis markers at the time of hospital admission, although the ventricular function recovered after a few days, as in other apical ballooning cases. TC is characterized by acute onset and quickly reversible left ventricular apical wall motion abnormalities with chest symptoms, ST-segment elevation and Twave inversion on ECG, minimal-moderate myocardial enzymatic release and no significant stenosis on coronary angiography (CAG).…”

Section: Discussionmentioning

confidence: 99%

Reversible Cardiomyopathy Associated with Autoimmune Polyendocrine Syndrome Type II

Karaveli̇oğlu

Baran²,

Karapınar

et al. 2013

Intern. Med.

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Recovery of the ventricular function in a patient with cardiomyopathy is very rare. Autoimmune polyendocrine syndrome is also very rare. We herein report a case of reversed cardiomyopathy associated with autoimmune polyendocrine syndrome type II (Schmidt's syndrome) composed of Addison's disease, vitiligo and Hashimoto's thyroiditis. The ventricular function and size were reversed following the administration of suitable hormone replacement therapy for polyendocrine syndrome.

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Section: Discussionmentioning

confidence: 99%

Reversible Cardiomyopathy Associated with Autoimmune Polyendocrine Syndrome Type II

Karaveli̇oğlu

Baran²,

Karapınar

et al. 2013

Intern. Med.

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“…It has been reported that norepinephrine is usually elevated in only 74% of the patients with TCM (Bybee, Prasad, et al, 2004). Lim et al (2009) argued for the potential influence of hormonal preconditioning in patients with autoimmune polyendocrine syndrome. Our patient may have experienced erratic overstimulation of catecholamines secondary to her persistent hypotension from her adrenal insufficiency and thus triggering TCM.…”

Section: Discussionmentioning

confidence: 99%

Takotsubo Cardiomyopathy in a Patient With Presumptive Autoimmune Polyendocrine Syndrome II

Yehya

Sperling

Jacobs

et al. 2011

Cardiac Cath Lab Director

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Takotsubo cardiomyopathy (TCM) is an increasingly described form of transient cardiomyopathy in which patients develop a distinct left ventricular apical ballooning typically following a significant emotional or physical stress. The etiology of this syndrome is not clear, but it is likely that direct catecholamine toxicity to the susceptible myocardium plays a role. The syndrome is most common in women and has been described in association with a variety of forms of physiologic or emotional stress. In general, the prognosis is favorable and complete recovery is common. The authors report the case of a young woman with presumed autoimmune polyendocrine syndrome II (APS II) who developed TCM after presenting with adrenal insufficiency. APS II is an endocrine disorder in which Addison's disease can occur with autoimmune thyroid disease, type 1 diabetes mellitus, premature ovarian failure, vitamin B12 deficiency, vitiligo, and other manifestations. Hormonal preconditioning and psychological stress may trigger TCM.T akotsubo cardiomyopathy (TCM) is a transient form of cardiomyopathy that is more frequently identified in patients following emotional and physical stress or worsening clinical status. The exact mechanism of TCM is still unraveled. It is characterized by apical akinesis and basal ventricular segment hyperkinesis and hence the ballooning pattern identified during systole. We report an uncommon presentation of TCM in a patient with adrenal insufficiency and presumed autoimmune polyendocrine syndrome II (APS II). The psychological stress superimposed on hormonal preconditioning is assumed to be the trigger for TCM in our patient. Case ReportA 26-year-old woman presented to the emergency department with a 1 month history of fatigue, nausea, vomiting, poor appetite, diarrhea, and a 15-kg weight loss. The patient has a known history of Hashimoto's disease with positive antithyroglobulin and antithyroid peroxidase antibodies. The patient is married, has quit smoking 1 year ago, drinks alcohol occasionally, and had a remote history of methamphetamine use. In the emergency department, she was in mild distress, appeared frail, anxious, and lethargic. On physical examination, the blood pressure was 90/64 mmHg, heart rate 110 beats per minute, respiratory rate 24 breaths per minute, temperature 36.2°C, and saturating 100% on 2-L oxygen. The patient's skin was clearly bronze, had palmar erythema and hyperpigmented mucous membranes. Cardiovascular exam was significant for tachycardia with regular rate and rhythm, and the abdomen was soft, mildly tender to palpation on the right upper quadrant.The laboratory data were significant for potassium 5.0 mmol/L, sodium 136 mmol/L, thyroid stimulating hormone 15.26 µIU/mL, free T4 0.7 ng/dL, troponin 2.9 ng/mL, creatine kinase (CK) 104 IU/L, creatine kinase-MB (CK/MB) 11 ng/mL, and brain natriuretic peptide (BNP) 2,285 pg/mL. Chest X-ray showed mild bilateral pleural effusion. The electrocardiogram showed diffuse ST abnormalities in the anterolateral region suggesting the possib...

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“…Several reports have described concomitant TTC and pericarditis, but the pathogenesis of the association between TTC and pericarditis remains unclear (1)(2)(3). On the other hand, an association of TTC with autoimmune disorders has been reported in the literature (4)(5)(6). Here, we present a case of TTC, complicated by pericarditis, in a patient with rheumatoid arthritis (RA).…”

Section: Introductionmentioning

confidence: 93%

Pericarditis-complicated takotsubo cardiomyopathy in a patient with rheumatoid arthritis

Mori

Yagi

et al. 2018

Cardiovasc. Diagn. Ther.

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A 64-year-old woman with medication-controlled rheumatoid arthritis (RA) was admitted to our hospital complaining of chest pains. An electrocardiogram showed elevated ST-segments in the inferior leads, and inverted T-waves in the left precordial leads. Left ventriculography demonstrated apical ballooning, and cardiac magnetic resonance imaging demonstrated apical ballooning of the left ventricle, and moderate pericardial effusion. The patient was diagnosed with takotsubo cardiomyopathy (TTC), complicated by pericarditis. In the literature, autoimmune disorders have been associated with TTC. We suggest that this patient's pericardial effusion was caused by TTC, and that her coexisting RA might have played a role in the etiology of the significant pericardial fluid accumulation.

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Takotsubo cardiomyopathy associated with autoimmune polyendocrine syndrome II

Cited by 14 publications

References 20 publications

Reversible Cardiomyopathy Associated with Autoimmune Polyendocrine Syndrome Type II

Reversible Cardiomyopathy Associated with Autoimmune Polyendocrine Syndrome Type II

Takotsubo Cardiomyopathy in a Patient With Presumptive Autoimmune Polyendocrine Syndrome II

Pericarditis-complicated takotsubo cardiomyopathy in a patient with rheumatoid arthritis

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