Takotsubo Cardiomyopathy Due to Diffuse Large B-Cell Lymphoma-Associated Hemophagocytic Lymphohistiocytosis.

BACKGROUND

Takotsubo cardiomyopathy (TCM) is a self-limited cardiomyopathy that improves with treatment of the underlying etiology. Although previously recognized as a transient and benign cardiomyopathy, the incidence of TCM continues to rise with increasing evidence for life-threatening complications such as cardiogenic shock.

CASE SUMMARY: We present the first reported case of a 56-year-old woman with cardiogenic shock from TCM due to hemophagocytic lymphohistiocytosis (HLH) secondary to Epstein-Barr Virus (EBV) associated diffuse large B-cell lymphoma (DLBCL). Treatment with DLBCL-directed chemotherapy during critical illness resulted in resolution of her acute cardiomyopathy and shock.

DISCUSSION: As in our case, the acute cytokine storm in HLH may result in TCM, a finding emphasizing the importance of assessing cardiac function in this patient cohort.

TAKE-HOME MESSAGE: This case highlights the importance of considering the risk of cardiomyopathy in patients with HLH.