Ullah Waqas, Hamid Mohsin, Grover Harshwant, Figueredo Vincent M, Inayat Faisal
Internal Medicine, Abington Hospital - Jefferson Health, Pennsylvania, USA.
Cardiology, St Mary Medical Center, Pennsylvania, USA.
BMJ Case Rep. 2019 Apr 23;12(4):e226599. doi: 10.1136/bcr-2018-226599.
Haemophagocytic lymphohistiocytosis (HLH) is an immune dysregulation disorder with variable presentations and non-specific features making it extremely difficult to diagnose early in the clinical course. Here, we are presenting a case of a young man who presented in cardiogenic shock with findings of anterolateral wall ischaemia on ECG. Echocardiography findings were consistent with takotsubo cardiomyopathy (TCM). Cardiac catheterisation showed clean coronary arteries and pulmonary artery pressure measurements showed high output cardiac failure. After extensive workup, the patient was diagnosed with HLH. In spite of aggressive supportive and definitive therapy, he eventually died due to a complicated clinical course. We did a comprehensive literature review and found that this is the first reported case of HLH presenting as TCM as the initial clinical manifestation.
噬血细胞性淋巴组织细胞增生症（HLH）是一种免疫调节紊乱性疾病，临床表现多样且缺乏特异性，这使得在临床病程早期极难诊断。在此，我们报告一例年轻男性病例，该患者因心源性休克就诊，心电图显示前侧壁缺血。超声心动图检查结果与应激性心肌病（TCM）相符。心导管检查显示冠状动脉正常，肺动脉压力测量显示高输出量心力衰竭。经过全面检查，该患者被诊断为HLH。尽管给予了积极的支持治疗和确定性治疗，但由于临床病程复杂，他最终死亡。我们进行了全面的文献回顾，发现这是首例以TCM作为初始临床表现的HLH报道病例。
