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Association between takotsubo syndrome and thrombocytopenia

Published:January 24, 2013DOI:https://doi.org/10.1016/j.ajem.2012.12.026
      We thank Katoh et al [
      • Katoh S.
      • Yamada Y.
      • Shinohe R.
      • Aoki K.
      • Abe M.
      Takotsubo cardiomyopathy associated with hypoglycemia: inverted takotsubo contractile pattern.
      ] for their interesting article. The authors reported takotsubo syndrome associated with hypoglycemia. We are also interested in takotsubo syndrome and recently reviewed this condition and its association. We found an interesting topic regarding association between takotsubo cardiomyopathy and thrombocytopenia. We would like to discuss the possible causes of thrombocytopenia in patients with takotsubo syndrome. Although there is no clear explanation for why patients with takotsubo syndrome can present with thrombocytopenia, there have been reports of this acute cardiomyopathy and thrombocytopenia related to thrombotic thrombocytopenic purpura [
      • Zhan H.
      • Zheng H.
      • Moliterno A.R.
      • Streiff M.B.
      Acute cardiomyopathy in a patient with thrombotic thrombocytopenic purpura.
      ] and seizure [
      • Stöllberger C.
      • Fischer H.
      • Pratter A.
      • Finsterer J.
      Seizure-induced Takotsubo cardiomyopathy and thrombocytopenia.
      ] in the literature. Renal insufficiency, fever, hemolytic anemia, or seizure in patients with takotsubo cardiomyopathy should raise the suspicion of thrombotic thrombocytopenic purpura.
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      References

        • Katoh S.
        • Yamada Y.
        • Shinohe R.
        • Aoki K.
        • Abe M.
        Takotsubo cardiomyopathy associated with hypoglycemia: inverted takotsubo contractile pattern.
        Am J Emerg Med. 2012; 30: 2098.e1-2098.e3
        • Zhan H.
        • Zheng H.
        • Moliterno A.R.
        • Streiff M.B.
        Acute cardiomyopathy in a patient with thrombotic thrombocytopenic purpura.
        Am J Med. 2010; 123: e3-e4
        • Stöllberger C.
        • Fischer H.
        • Pratter A.
        • Finsterer J.
        Seizure-induced Takotsubo cardiomyopathy and thrombocytopenia.
        Eur J Neurol. 2011; 18: e68-e69