Takotsubo Syndrome in a Rheumatoid Arthritis Patient Under Tofacitinib: A Case Report

Autores da FMUP

• Elisabete Lousada Martins Oliveira Bernardes

  Autor

• Sofia Santos Pimenta Vale

  Autor

Participantes de fora da FMUP

• Garcia, S
• Terroso, G
• Costa, L
• Bernardes, MAB -

Unidades de investigação

• Laboratório Associado RISE- Rede de Investigação em Saúde

  

  Investigador

  Fernando Carlos De Landér Schmitt

• Medicina

• RISE-Health

  

  Investigador

  Fernando Carlos De Landér Schmitt

Abstract

We describe a case of a 57-year-old white woman treated for rheumatoid arthritis (RA) with tofacitinib 10 mg daily (started one year ago) and prednisolone 5 mg daily. She presented to the emergency department with a tight squeezing chest pain and shortness of breath for 7 h and the clinical evaluation revealed regional systolic dysfunction of the left ventricle, mimicking a myocardial infarction, in the absence of angiographic evidence of obstructive coronary artery disease or acute plaque rupture. All changes were transient and resolved completely within 4 days. The diagnosis of Takotsubo cardiomyopathy (TKM) was established. This is, as far as we know, the first report of a case of TKM in a RA patient taking tofacitinib. Although the association has not been previously described and the precise cause cannot be identified in this patient, the association with tofacitinib should be considered given the etiopathogenic rationale and the absence of any other identifiable cause. © 2021 Elsevier España, S.L.U. and Sociedad Española de Reumatología y Colegio Mexicano de Reumatología

Keywords

• Arthritis, Rheumatoid; Female; Humans; Middle Aged; Piperidines; Prednisolone; Pyrimidines; Takotsubo Cardiomyopathy; abatacept; creatine kinase MB; cyclic citrullinated peptide antibody; etanercept; golimumab; leflunomide; methotrexate; prednisolone; tocilizumab; tofacitinib; troponin I; piperidine derivative; prednisolone; pyrimidine derivative; tofacitinib; adult; Article; cardiovascular magnetic resonance; case report; clinical article; drug substitution; drug withdrawal; dyspnea; electrocardiogram; emergency ward; female; heart catheterization; heart left ventricle contraction; human; hypertension; liver toxicity; medical history; middle aged; myocardial perfusion imaging; Q wave; rheumatoid arthritis; T wave; takotsubo cardiomyopathy; thorax pain; vital sign; complication; rheumatoid arthritis; takotsubo cardiomyopathy