{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T12:16:27Z","timestamp":1756383387985,"version":"3.44.0"},"reference-count":18,"publisher":"BMJ","issue":"4","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2019,3,29]]},"published-print":{"date-parts":[[2019,4]]},"abstract":"<jats:p>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.<\/jats:p>","DOI":"10.1136\/bcr-2018-226599","type":"journal-article","created":{"date-parts":[[2019,4,23]],"date-time":"2019-04-23T16:07:16Z","timestamp":1556035636000},"page":"e226599","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":6,"title":["Takotsubo cardiomyopathy secondary to haemophagocytic lymphohistiocytosis in HIV patients: a comprehensive review"],"prefix":"10.1136","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4850-0309","authenticated-orcid":false,"given":"Waqas","family":"Ullah","sequence":"first","affiliation":[{"name":"Internal Medicine, Abington Hospital - Jefferson Health, Pennsylvania, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7105-4802","authenticated-orcid":false,"given":"Mohsin","family":"Hamid","sequence":"additional","affiliation":[{"name":"Internal Medicine, Abington Hospital - Jefferson Health, Pennsylvania, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Harshwant","family":"Grover","sequence":"additional","affiliation":[{"name":"Internal Medicine, Abington Hospital - Jefferson Health, Pennsylvania, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vincent M","family":"Figueredo","sequence":"additional","affiliation":[{"name":"Cardiology, St Mary Medical Center, Pennsylvania, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Faisal","family":"Inayat","sequence":"additional","affiliation":[{"name":"Internal Medicine, Allama Iqbal Medical College, Lahore, Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2019,4,23]]},"reference":[{"key":"2025082708400382000_12.4.e226599.1","doi-asserted-by":"publisher","DOI":"10.1136\/bcr-2016-215366"},{"key":"2025082708400382000_12.4.e226599.2","doi-asserted-by":"crossref","first-page":"69","DOI":"10.2147\/JBM.S46255","article-title":"Hemophagocytic lymphohistiocytosis: review of etiologies and management","volume":"5","author":"George","year":"2014","journal-title":"J Blood Med"},{"key":"2025082708400382000_12.4.e226599.3","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(07)70290-6"},{"key":"2025082708400382000_12.4.e226599.4","doi-asserted-by":"crossref","first-page":"561","DOI":"10.1097\/PEC.0000000000000189","article-title":"A 6-year-old girl with undiagnosed hemophagocytic lymphohistiocytosis and takotsubo cardiomyopathy: a case report and review of the literature","volume":"30","author":"Otillio","year":"2014","journal-title":"Pediatr Emerg Care"},{"key":"2025082708400382000_12.4.e226599.5","doi-asserted-by":"crossref","first-page":"172","DOI":"10.1186\/s12887-016-0718-3","article-title":"A case of Epstein-Barr virus-associated hemophagocytic lymphohistiocytosis with severe cardiac complications","volume":"16","author":"Kawamura","year":"2016","journal-title":"BMC Pediatr"},{"key":"2025082708400382000_12.4.e226599.6","doi-asserted-by":"crossref","first-page":"1688","DOI":"10.1002\/pbc.26060","article-title":"Hemophagocytic Lymphohistiocytosis With Secondary Atrioventricular Block Type II in a Child","volume":"63","author":"Liu","year":"2016","journal-title":"Pediatr Blood Cancer"},{"key":"2025082708400382000_12.4.e226599.7","doi-asserted-by":"crossref","first-page":"459","DOI":"10.1097\/MPH.0000000000000257","article-title":"Hypertrophic Obstructive Cardiomyopathy in An Infant With Hemophagocytic Lymphohistiocytosis; Answer to a Riddle","volume":"37","author":"Rabah","year":"2015","journal-title":"J Pediatr Hematol Oncol"},{"key":"2025082708400382000_12.4.e226599.8","unstructured":"Sanklecha M , Mehta N , Bagban H . 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