Inverted Takotsubo Cardiomyopathy Triggered by Corticosteroid Administration in a Patient with Undiagnosed Pheochromocytoma

Q: What is the clinical evidence from this study?

Study design: Case Report. Population: Inverted Takotsubo Cardiomyopathy and Pheochromocytoma (n=1). Intervention: Methylprednisolone. Primary outcome: Development of inverted Takotsubo cardiomyopathy.

Viviana Mendoza; Tania Ramos García; Ana Novalbos; Francisco Vega; Carlos Blanco

doi:10.18176/jiaci.1188

July 29, 2026Journal of Investigational Allergology and Clinical ImmunologyOpen Access

Inverted Takotsubo Cardiomyopathy Triggered by Corticosteroid Administration in a Patient with Undiagnosed Pheochromocytoma

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Key result

Methylprednisolone triggers inverted Takotsubo cardiomyopathy and cardiogenic shock in a patient with undiagnosed pheochromocytoma.

n=1

Key Points

To describe a case of severe inverted Takotsubo cardiomyopathy and multiorgan failure provoked by therapeutic corticosteroid administration in a patient with an occult pheochromocytoma.
Evaluated a 74-year-old woman presenting with suspected drug hypersensitivity following Takotsubo cardiomyopathy after intramuscular methylprednisolone 80 mg.
Conducted a controlled oral drug challenge with methylprednisolone 40 mg administered as two 20-mg doses under clinical monitoring.
Performed diagnostic evaluations including echocardiography, cardiac magnetic resonance imaging, urinary catecholamine assays, and adrenal computed tomography.
Provocation testing with methylprednisolone 40 mg induced cardiogenic shock, metabolic acidosis, troponin elevation to 5998 ng/L, and a decline in left ventricular ejection fraction to 15%.
Cardiac magnetic resonance imaging demonstrated basal lateral left ventricular edema with preserved apical function, confirming the inverted Takotsubo variant.
Diagnostic workup revealed elevated urinary adrenaline (94 µg/L) and noradrenaline (110 µg/L) secondary to a 24×33-mm right adrenal pheochromocytoma, with left ventricular ejection fraction recovering to 65% following right adrenalectomy.

Study Design

Type

Case Report (n=1)

Multicenter

No

PICO

P

Population

A 74-year-old woman with undiagnosed pheochromocytoma who developed inverted Takotsubo cardiomyopathy following corticosteroid administration.

E

Exposure / Comparator

Methylprednisolone (40 mg to 80 mg)

O

Primary Outcome

Development of inverted Takotsubo cardiomyopathy

Implication

Case report demonstrates inverted Takotsubo cardiomyopathy triggered by corticosteroids in undiagnosed pheochromocytoma, highlighting the risk of amplified catecholamine cardiotoxicity.

Abstract

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Discussion

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Cite This Study

Mendoza et al. (2026) conducted a case report in Inverted Takotsubo Cardiomyopathy and Pheochromocytoma (n=1). Methylprednisolone was evaluated on Development of inverted Takotsubo cardiomyopathy. Administration of methylprednisolone triggered inverted Takotsubo cardiomyopathy and cardiogenic shock in a patient with an undiagnosed pheochromocytoma.

synapsesocial.com/papers/6a6c55c2747664a1aa73d722 https://doi.org/10.18176/jiaci.1188

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Inverted Takotsubo Cardiomyopathy Triggered by Corticosteroid Administration in a Patient with Undiagnosed Pheochromocytoma

Key Points

Study Design

PICO

Implication

Abstract

Discussion

Cite This Study

Inverted Takotsubo Cardiomyopathy Triggered by Corticosteroid Administration in a Patient with Undiagnosed Pheochromocytoma

Key Points

Study Design

PICO

Implication

Abstract

Discussion

Cite This Study

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