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

Juka S Kim1, Angela Ai2, Kathryn H Melamed3

  • 1Department of Medicine, Stanford University, Stanford, California, USA.

JACC. Case Reports
|June 20, 2025
PubMed

Insights

Takotsubo cardiomyopathy (TCM) can cause life-threatening cardiogenic shock. This case shows TCM in a patient with hemophagocytic lymphohistiocytosis (HLH) secondary to lymphoma, emphasizing cardiac assessment in HLH.

Area of Science:

  • Cardiology
  • Oncology
  • Hematology

Background:

  • Takotsubo cardiomyopathy (TCM) is typically self-limited but can present with severe complications like cardiogenic shock.
  • The incidence of TCM is rising, necessitating a broader understanding of its potential etiologies and severe presentations.

Observation:

  • A 56-year-old woman developed cardiogenic shock due to TCM.
  • The TCM was secondary to hemophagocytic lymphohistiocytosis (HLH) triggered by Epstein-Barr Virus (EBV)-associated diffuse large B-cell lymphoma (DLBCL).

Findings:

  • The patient's acute cardiomyopathy and shock resolved following DLBCL-directed chemotherapy.
  • The acute cytokine storm associated with HLH was identified as the likely cause of TCM in this case.

Implications:

  • This case underscores the critical importance of assessing cardiac function in patients with HLH.
  • Clinicians should consider TCM as a potential complication in patients with HLH, particularly those experiencing a cytokine storm.
Abstract

Keywords:
acute heart failurecardiomyopathyechocardiographyreduced ejection fraction

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