Key result
Platelet transfusion triggers reversible Takotsubo cardiomyopathy and TACO, resolving within one week after diuretics.
Case Report (n=1)
No
This case demonstrates that an allergic reaction to platelet transfusion can trigger Takotsubo cardiomyopathy presenting as transfusion-associated circulatory overload (TACO), suggesting Takotsubo cardiomyopathy may underlie some cases diagnosed as TACO.
Consider Takotsubo cardiomyopathy in TACO after platelet transfusion; case report leaves open causality and generalizability.
: An 85-year-old man with non-Hodgkinʼs lymphoma received a platelet transfusion for thrombocytopenia following chemotherapy. He developed wheezing and dyspnea 20min after the start of the transfusion. A transthoracic echocardiogram revealed severe left ventricular dysfunction (EF 27.3%) and severe apical hypokinesis with dispro-portionately preserved contraction of the basal segment, suggestive of Takotsubo cardiomyopathy. The patient re-sponded well to a diuretic and the echocardiography findings returned to normal. Takotsubo cardiomyopathy is often associated with a physical or psychological stress that induces sympathetic nerve activity. In our case, allergic reaction to platelet transfusion is likely to be such a stress. Our case also fulfilled the diagnostic criteria of transfusion-associated circulatory overload (TACO), which is a representative adverse reaction to blood transfusion. This sug-gests that patients diagnosed with TACO may have Takotsubo cardiomyopathy, which may be involved in pathogenesis of TACO. A large study is required to elucidate the pathogenesis of heart failure following blood transfusion.
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Yamanouchi et al. (2020) conducted a case report in Takotsubo cardiomyopathy and transfusion-associated circulatory overload (TACO) during platelet transfusion in a patient with relapsed diffuse large B-cell lymphoma (n=1). Platelet transfusion (trigger) and subsequent hydrocortisone and diuretic therapy was evaluated on Left ventricular ejection fraction (EF) and recovery of apical wall motion abnormality. Platelet transfusion triggered Takotsubo cardiomyopathy with severe left ventricular dysfunction (EF 27.3%) and TACO in an 85-year-old man, which normalized (EF 74.3%) within 1 week after diuretic therapy.
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