Takotsubo cardiomyopathy secondary to haemophagocytic lymphohistiocytosis in HIV patients: a comprehensive review

Ullah, Waqas; Hamid, Mohsin; Grover, Harshwant; Figueredo, Vincent M.; Inayat, Faisal

doi:10.1136/bcr-2018-226599

Cited by 5 publications

(7 citation statements)

References 16 publications

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“…Fifteen studies that met the quality appraisal are included in the systematic review, as discussed in Table 1 [14][15][16][17][18][19][20][21][22][23][24][25][26][27][28].…”

Section: Resultsmentioning

confidence: 99%

“…A biopsy was available for confirmation in only one case, but four cases were diagnosed with myocarditis. We were not the only ones to diagnose Takotsubo cardiomyopathy because one other patient presented with fever and fatigue as opposed to ours [ 28 ]. The presence of hypertrophic obstructive cardiomyopathy in two instances associated with HLH is interesting to note.…”

Section: Reviewmentioning

confidence: 99%

“…Fifteen studies that met the quality appraisal are included in the systematic review, as discussed in Table 1 [ 14 - 28 ].…”

Section: Reviewmentioning

confidence: 99%

“…It was a comprehensive literature review. According to the study, only nine cases of cardiac complications were reported to be associated with hemophagocytic lymphocytosis (HLH) [ 28 ]. Four of the nine patients reported were adults, while five were children.…”

Section: Reviewmentioning

confidence: 99%

“…It was eventually possible for most patients to recover. There has not been any case reported in which HIV was the inciting event for HLH nor have any cases been reported in which cardiogenic shock with global hypokinesia was the presenting symptom [ 28 ].…”

Section: Reviewmentioning

confidence: 99%

See 4 more Smart Citations

A Systematic Review Exploring the Effect of Human Immunodeficiency Virus on Cardiac Diseases

Alzubaidee¹,

Dwarampudi²,

Mathew³

et al. 2022

Cureus

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Human immunodeficiency virus (HIV) primarily affects the immune systems, which, if progressed, will lead to acquired immunodeficiency syndrome (AIDS). Currently, there is no effective cure for the disease, and patients are affected lifelong, but there are antiretroviral medications that can control the disease's symptoms and progression. In addition, taking precautions during sexual contact, especially in the male homosexual population, while handling the patient's bodily fluids such as blood and saliva, and during childbirth by an infected mother is necessary to prevent the transmission of the virus. We used 15 studies, including systematic reviews and meta-analyses, observation studies, randomized clinical trials, and comprehensive reviews, to determine how HIV interferes with heart disease, increasing morbidity and mortality. We have used specific inclusion and exclusion criteria, focusing on specified age groups within a particular timeline. Some of the included studies found that many side effects from antiretroviral drugs can impact heart conditions, along with HIV, while others did not show a strong correlation between HIV and some heart diseases. In conclusion, after reviewing the literature, the results are inconclusive. More extensive trials focusing on the impact HIV has on heart disease are required to establish a strong correlation between HIV and heart disease to prevent morbidity and mortality.

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“…Fifteen studies that met the quality appraisal are included in the systematic review, as discussed in Table 1 [14][15][16][17][18][19][20][21][22][23][24][25][26][27][28].…”

Section: Resultsmentioning

confidence: 99%

Section: Reviewmentioning

confidence: 99%

“…Fifteen studies that met the quality appraisal are included in the systematic review, as discussed in Table 1 [ 14 - 28 ].…”

Section: Reviewmentioning

confidence: 99%

Section: Reviewmentioning

confidence: 99%

Section: Reviewmentioning

confidence: 99%

See 3 more Smart Citations

A Systematic Review Exploring the Effect of Human Immunodeficiency Virus on Cardiac Diseases

Alzubaidee¹,

Dwarampudi²,

Mathew³

et al. 2022

Cureus

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Haemophagocytic lymphohistiocytosis (HLH)-associated stress cardiomyopathy secondary to autoimmune conditions successfully treated with anakinra

et al. 2021

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We describe two young cases of reactive haemophagocytic lymphohistiocytosis (HLH) with the resultant stress cardiomyopathy in the setting of underlying autoimmune diseases, systemic lupus erythematosus (SLE) and Still’s disease. The initial presentation was similar in both cases with fever, hyperinflammatory response, hypotension (vasoplegia), bicytopenia and hyperferritinemia. Despite standard of care and multiple broad-spectrum antibiotics, both cases remained pyrexic and were ultimately admitted to the intensive therapy unit to treat cardiogenic shock. Echocardiogram of both cases showed low ejection fraction, the cause for which was not found until the final diagnosis of HLH was made. Both cases made a complete clinical and cardiac recovery following the initiation of high-dose glucocorticoids and anakinra.

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Macrophage Activation Led Acute Heart Failure Managed Successfully with Immunosuppression

Seegobin¹,

Moustafa²,

Majeed³

et al. 2021

JBM

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Macrophage activation leading to multi-organ dysfunction/failure has been described in various hematologic disorders like hemophagocytic lympho-histiocytosis (HLH), also known as macrophage activation syndrome (MAS) and macrophage activation like syndrome (MALS). Congestive heart failure (CHF) appears to be an uncommon manifestation of macrophage activation. This novel entity of macrophage activationassociated cytokine-mediated CHF has not been well reported in the medical literature. We report two young female patients with acute CHF secondary to macrophage activationassociated cytokine storm. An extensive diagnostic workup was negative for other etiologies, such as ischemia, myocarditis, or infections. Their clinical, laboratory, and pathologic findings did not meet the diagnostic criteria for hemophagocytic syndrome (HPS)/MAS. However, both had laboratory and pathologic findings which were consistent with macrophage activation and cytokine storm. One patient met criteria for MALS. Therapeutically, our patients were promptly treated with steroids with or without anti-cytokine therapy with rapid restoration of cardiac function. Macrophage activation-induced disease may not always fulfil the diagnostic criteria for the currently known macrophage activation disorders. We suggest that markers of macrophage activation and cytokine levels should be part of the diagnostic workup in patients with otherwise unexplained acute CHF. Additional research is warranted to further elucidate the underlying mechanism of this disorder.

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Takotsubo cardiomyopathy secondary to haemophagocytic lymphohistiocytosis in HIV patients: a comprehensive review

Cited by 5 publications

References 16 publications

A Systematic Review Exploring the Effect of Human Immunodeficiency Virus on Cardiac Diseases

A Systematic Review Exploring the Effect of Human Immunodeficiency Virus on Cardiac Diseases

Haemophagocytic lymphohistiocytosis (HLH)-associated stress cardiomyopathy secondary to autoimmune conditions successfully treated with anakinra

Macrophage Activation Led Acute Heart Failure Managed Successfully with Immunosuppression

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