title: A 6-year-old girl with undiagnosed hemophagocytic lymphohistiocytosis and takotsubo cardiomyopathy: a case report and review of the literature.
abstract: Hemophagocytic lymphohistiocytosis (HLH) is a rare disorder of highly stimulated immune responses to antigens that leads to life-threatening inflammation and multiple organ dysfunction. At presentation, HLH may uncommonly mimic septic shock. In this case, we present a 6-year-old girl presenting to the pediatric emergency department with a febrile illness and anemia that subsequently developed decompensated shock, initially thought to be septic. She was ultimately diagnosed with HLH. During initial HLH treatment, this patient also developed takotsubo cardiomyopathy, a unique pattern of reversible left ventricular dysfunction characterized by transient apical ballooning and hypokenesis of the left ventricle that spontaneously resolves. There are very few case reports of HLH-associated takotsubo cardiomyopathy. We believe that this is the first case of takotsubo cardiomyopathy in a child with HLH.
authors.affiliation: From the Divisions of *Pediatric Emergency Medicine and †Pediatric Cardiology, Department of Pediatrics, Medical University of South Carolina, Charleston, SC.
authors.forename: Jaime Kaye
authors.initials: JK
authors.lastname: Otillio
authors.forename: Jeffrey K
authors.initials: JK
authors.lastname: Harris
authors.forename: Rachel
authors.initials: R
authors.lastname: Tuuri
mesh_terms: D001803:Blood Transfusion; D002648:Child; D005260:Female; D006801:Humans; D051359:Lymphohistiocytosis, Hemophagocytic / Q000150:complications* / Q000628:therapy; D009200:Myocardial Contraction; D054549:Takotsubo Cardiomyopathy / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy