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Vol. 18. Issue 8.
Pages 493-494 (October 2022)
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Vol. 18. Issue 8.
Pages 493-494 (October 2022)
Case report
Takotsubo Syndrome in a Rheumatoid Arthritis Patient Under Tofacitinib: A Case Report
Síndrome de takotsubo en un paciente con artritis reumatoide tomando tofacitinib: reporte de un caso
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Salomé Garciaa,
Corresponding author
salomefernandesgarcia@gmail.com

Corresponding author.
, Georgina Terrosoa, Elisabete Martinsb, Sofia Pimentaa, Lúcia Costaa, Miguel Bernardesa
a Rheumatology Department, Centro Hospitalar de São João, Porto, Portugal
b Cardiology Department, Centro Hospitalar de São João, Porto, Portugal
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Abstract

We describe a case of a 57-year-old white woman treated for rheumatoid arthritis (RA) with tofacitinib 10mg daily (started one year ago) and prednisolone 5mg daily. She presented to the emergency department with a tight squeezing chest pain and shortness of breath for 7h 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.

Keywords:
Rheumatoid arthritis
Tofacitinib
Takotsubo
Cardiomyopathy
Resumen

Describimos el caso de una mujer blanca de 57 años tratada por artritis reumatoide (AR) con tofacitinib 10mg al día (iniciado hace un año) y prednisolona 5mg al día. Acudió al servicio de Urgencias con dolor torácico opresivo y dificultad para respirar durante 7 h y la evaluación clínica reveló disfunción sistólica regional del ventrículo izquierdo, simulando un infarto de miocardio, en ausencia de evidencia angiográfica de enfermedad arterial coronaria obstructiva o aguda. rotura de placa. Todos los cambios fueron transitorios y se resolvieron por completo en 4 días. Se estableció el diagnóstico de miocardiopatía de takotsubo (TKM). Este es, hasta donde sabemos, el primer informe de un caso de TKM en un paciente con AR que toma tofacitinib. Aunque la asociación no se ha descrito previamente y no se puede identificar la causa precisa en este paciente, la asociación con tofacitinib debe considerarse dada la justificación etiopatogénica y la ausencia de cualquier otra causa identificable.

Palabras clave:
Artritis reumatoide
Tofacitinib
Takotsubo
Cardiomiopatía

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