Severe transient left ventricular pseudohypertrophy during treatment of hemophagocytic lymphohistiocytosis:  a case report.
BACKGROUND
An association between hemophagocytic lymphohistiocytosis (HLH) and severe transient left ventricular (LV) hypertrophy has not been described to date. Possible explanations, including etoposide toxicity, are discussed.


METHODS
A 2-month-old male infant with HLH was treated according to the HLH-2004 protocol. Initial cardiac evaluation was within normal limits. During the second month of therapy, a heart murmur was discovered; electrocardiogram demonstrated signs of LV hypertrophy, and echocardiogram confirmed the presence of thickness of LV walls. This complication was transient: clinical findings, echocardiogram, and electrocardiogram recorded 6 months afterward were all within normal limits.


CONCLUSIONS
The case suggests the need for close echocardiographic monitoring during HLH treatment.
Department of Hematooncology, Mother and Child Health Institute, Dr Vukan Cupic, School of Medicine, University of Belgrade, Belgrade, Serbia.
Milos
M
Kuzmanovic
Srdjan
S
Pasic
Sergej
S
Prijic
Ankica
A
Jovanovic
Jovan
J
Kosutic
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects*; D016572:Cyclosporine / Q000008:administration & dosage; D003907:Dexamethasone / Q000008:administration & dosage; D004452:Echocardiography; D004562:Electrocardiography; D005047:Etoposide / Q000008:administration & dosage; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000139:chemically induced* / Q000517:prevention & control*; D007223:Infant; D051359:Lymphohistiocytosis, Hemophagocytic / Q000188:drug therapy*; D008297:Male; D011379:Prognosis
D005047:Etoposide; D003907:Dexamethasone; D016572:Cyclosporine