Takotsubo cardiomyopathy and thrombotic thrombocytopenic purpura can be rare initial presentations preceding a formal diagnosis of systemic lupus erythematosus, highlighting the need for careful clinical follow-up.
May prompt SLE evaluation in atypical Takotsubo with TTP; leaves open prevalence and causality in larger cohorts.
Takotsubo cardiomyopathy, a rare stress-related cardiomyopathy, has been observed in a few cases secondary to systemic lupus erythematosus (SLE). Herein, we report an unusual case where a postmenopausal woman presented initially with Takotsubo syndrome, later developed thrombotic thrombocytopenic purpura and cerebrovascular events, initially without clinical or laboratory features of SLE. During the course of her illness, she was found to satisfy four of the Systemic Lupus International Collaborating Clinics classification criteria for a SLE diagnosis. This unique presentation of our patient, initially with Takotsubo cardiomyopathy, the development of thrombotic thrombocytopenic purpura and cerebrovascular events preceding the diagnosis of SLE illustrates the importance of clinical observation and follow-up.
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Georgiades et al. (2015) studied this question.
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