Apical ballooning and cardiomyopathy in a melanoma patient treated with ipilimumab: a case of takotsubo-like syndrome

Journal for ImmunoTherapy of Cancer

David R Schwartz¹  Elad Sharon²  Diana Esaian¹  Roy A Raad¹  Benjamin P Geisler¹ 

[1] New York University School of Medicine, New York 10016, NY, USA;National Cancer Institute, Bethesda 20892, MD, USA

关键词: Drug-related side effects and adverse reactions;    Melanoma;    Ipilimumab [Supplementary concept];    Takotsubo cardiomyopathy;   

Others  :  1133480
DOI  :  10.1186/s40425-015-0048-2

 received in 2014-08-14, accepted in 2015-02-03,  发布年份 2015

【 摘 要 】

Although animal studies have shown that the immunomodulator ipilimumab causes inflammation of the myocardium, clinically significant myocarditis has been observed only infrequently. We report a case of suspected acute coronary syndrome without a culprit lesion on cardiac angiography and takotsubo cardiomyopathy (TC)-like appearance on echocardiography in a patient with metastatic melanoma who received four standard doses of ipilimumab. Apical ballooning, hyperdynamic basal wall motion, systolic anterior motion of the mitral valve, and associated severe left ventricular outflow tract obstruction were present. Restaging with positron emission tomography-computed tomography done soon after discharge incidentally revealed increased fludeoxyglucose uptake in the apex. This case illustrates that a TC-like syndrome might be caused by autoimmune myocarditis after ipilimumab treatment although this was not biopsy-confirmed. Post-marketing surveillance should capture cardiac events occurring in patients treated with ipilimumab to better document and clarify a relationship to the drug, and biopsies should be considered. Physicians utilizing this novel agent should be aware of the potential for immune-related adverse events.

【 授权许可】

   
2015 Geisler et al.; licensee BioMed Central.

【 图 表 】

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