Takotsubo syndrome associated with autoimmune limbic encephalitis: a case report

Abstract Background Central nervous system diseases are common triggers of Takotsubo syndrome. We herein report a rare case of Takotsubo syndrome associated with autoimmune limbic encephalitis. Case presentation A 68-year-old Japanese woman presented to our emergency room with disturbed consciousnes...

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Main Authors: Yuki Kakinuma, Taro Kimura, Yoshiki Sakae, Satomi Kubota, Kenjiro Ono, Ryuta Kinno
Format: Article
Language:English
Published: BMC 2021-02-01
Series:BMC Cardiovascular Disorders
Subjects:
Online Access:https://doi.org/10.1186/s12872-020-01789-3
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author Yuki Kakinuma
Taro Kimura
Yoshiki Sakae
Satomi Kubota
Kenjiro Ono
Ryuta Kinno
author_facet Yuki Kakinuma
Taro Kimura
Yoshiki Sakae
Satomi Kubota
Kenjiro Ono
Ryuta Kinno
author_sort Yuki Kakinuma
collection DOAJ
description Abstract Background Central nervous system diseases are common triggers of Takotsubo syndrome. We herein report a rare case of Takotsubo syndrome associated with autoimmune limbic encephalitis. Case presentation A 68-year-old Japanese woman presented to our emergency room with disturbed consciousness. At admission, she showed hypoxemia. Left ventriculography showed akinesia in the middle part of the left ventricle and hyperkinesia in the apical and basal parts of the left ventricle, and the diagnosis of midventricular Takotsubo syndrome was established. However, after an improvement in disturbed consciousness and Takotsubo syndrome symptoms, her brother noticed something wrong with her behavior during his visit to the hospital. Subsequently, we consulted the neurology department 1 week after admission. Her brother revealed a history of abnormal behavior by the patient (such as mistaken entry in the wrong apartment in her building or in another person’s car) a few days prior to the onset of disturbed consciousness, suggesting disorientation of place. Brain magnetic resonance imaging showed an increased signal in the medial aspect of the temporal lobes, which was most clearly observed on the fluid-attenuated inversion recovery sequence; additionally, a cerebrospinal fluid analysis revealed mild lymphocytic pleocytosis. Finally, we established a diagnosis of midventricular Takotsubo syndrome associated with autoimmune limbic encephalitis. Conclusions It is presumed that the dysfunction of limbic system due to autonomic limbic encephalopathy is associated with exaggerated sympathetic stimulation. This likely resulted in Takotsubo syndrome in our patient.
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spelling doaj.art-4687b68dbbc34b989c4d81dbb8fdbb0f2022-12-21T22:26:58ZengBMCBMC Cardiovascular Disorders1471-22612021-02-012111710.1186/s12872-020-01789-3Takotsubo syndrome associated with autoimmune limbic encephalitis: a case reportYuki Kakinuma0Taro Kimura1Yoshiki Sakae2Satomi Kubota3Kenjiro Ono4Ryuta Kinno5Division of Neurology, Department of Internal Medicine, Showa University Northern Yokohama HospitalDivision of Cardiology & Cardiac Catheterization Laboratories, Showa University Northern Yokohama HospitalDivision of Neurology, Department of Internal Medicine, Showa University Northern Yokohama HospitalDivision of Neurology, Department of Internal Medicine, Showa University Northern Yokohama HospitalDivision of Neurology, Department of Medicine, Showa University, School of MedicineDivision of Neurology, Department of Internal Medicine, Showa University Northern Yokohama HospitalAbstract Background Central nervous system diseases are common triggers of Takotsubo syndrome. We herein report a rare case of Takotsubo syndrome associated with autoimmune limbic encephalitis. Case presentation A 68-year-old Japanese woman presented to our emergency room with disturbed consciousness. At admission, she showed hypoxemia. Left ventriculography showed akinesia in the middle part of the left ventricle and hyperkinesia in the apical and basal parts of the left ventricle, and the diagnosis of midventricular Takotsubo syndrome was established. However, after an improvement in disturbed consciousness and Takotsubo syndrome symptoms, her brother noticed something wrong with her behavior during his visit to the hospital. Subsequently, we consulted the neurology department 1 week after admission. Her brother revealed a history of abnormal behavior by the patient (such as mistaken entry in the wrong apartment in her building or in another person’s car) a few days prior to the onset of disturbed consciousness, suggesting disorientation of place. Brain magnetic resonance imaging showed an increased signal in the medial aspect of the temporal lobes, which was most clearly observed on the fluid-attenuated inversion recovery sequence; additionally, a cerebrospinal fluid analysis revealed mild lymphocytic pleocytosis. Finally, we established a diagnosis of midventricular Takotsubo syndrome associated with autoimmune limbic encephalitis. Conclusions It is presumed that the dysfunction of limbic system due to autonomic limbic encephalopathy is associated with exaggerated sympathetic stimulation. This likely resulted in Takotsubo syndrome in our patient.https://doi.org/10.1186/s12872-020-01789-3Autoimmune limbic encephalitisCase reportLimbic systemStress cardiomyopathyTakotsubo syndrome
spellingShingle Yuki Kakinuma
Taro Kimura
Yoshiki Sakae
Satomi Kubota
Kenjiro Ono
Ryuta Kinno
Takotsubo syndrome associated with autoimmune limbic encephalitis: a case report
BMC Cardiovascular Disorders
Autoimmune limbic encephalitis
Case report
Limbic system
Stress cardiomyopathy
Takotsubo syndrome
title Takotsubo syndrome associated with autoimmune limbic encephalitis: a case report
title_full Takotsubo syndrome associated with autoimmune limbic encephalitis: a case report
title_fullStr Takotsubo syndrome associated with autoimmune limbic encephalitis: a case report
title_full_unstemmed Takotsubo syndrome associated with autoimmune limbic encephalitis: a case report
title_short Takotsubo syndrome associated with autoimmune limbic encephalitis: a case report
title_sort takotsubo syndrome associated with autoimmune limbic encephalitis a case report
topic Autoimmune limbic encephalitis
Case report
Limbic system
Stress cardiomyopathy
Takotsubo syndrome
url https://doi.org/10.1186/s12872-020-01789-3
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