title: Takotsubo cardiomyopathy and thrombotic thrombocytopenic purpura preceding a lupus diagnosis: a case report.
abstract: 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.
authors.affiliation: St George's, University of London at the University of Nicosia, Nicosia, Cyprus georgiades.f@live.sgul.ac.cy.
authors.forename: F
authors.initials: F
authors.lastname: Georgiades
authors.affiliation: St George's, University of London at the University of Nicosia, Nicosia, Cyprus.
authors.forename: S
authors.initials: S
authors.lastname: Demosthenous
authors.affiliation: Haematology Department, Nicosia General Hospital, Nicosia, Cyprus.
authors.forename: M
authors.initials: M
authors.lastname: Braimi
authors.affiliation: Haematology Department, Nicosia General Hospital, Nicosia, Cyprus.
authors.forename: T
authors.initials: T
authors.lastname: Tsitskari
authors.affiliation: St George's, University of London at the University of Nicosia, Nicosia, Cyprus Rheumatology Department, Nicosia General Hospital, Nicosia, Cyprus.
authors.forename: S
authors.initials: S
authors.lastname: Psarelis
mesh_terms: D000208:Acute Disease; D056988:Anterior Wall Myocardial Infarction / Q000175:diagnosis / Q000188:drug therapy; D000974:Antibodies, Antinuclear / Q000032:analysis; D003937:Diagnosis, Differential; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D008875:Middle Aged; D011697:Purpura, Thrombotic Thrombocytopenic / Q000150:complications / Q000175:diagnosis*; D054549:Takotsubo Cardiomyopathy / Q000150:complications / Q000175:diagnosis*; D016896:Treatment Outcome
chemical_list: D000974:Antibodies, Antinuclear
keywords: SLE; SLICC; TTP; Takotsubo cardiomyopathy