Rituximab-induced Takotsubo syndrome: more cardiotoxic than it appears?

BMJ Case Reports
Kien Hoe NgPascale Gruber

Abstract

Rituximab is used for treatment of multiple haematological cancers. Caution for use is advised in patients with significant cardiorespiratory disease due to known cases of exacerbations of angina and arrhythmias. However, its cardiotoxicity profile is not as well recognised as other monoclonal antibodies such as transtuzumab. We report a case of a 66-year-old man who developed Takotsubo's cardiomyopathy (TC) after an elective infusion of rituximab. This case is exceptional in that rituximab has not been linked to TC, and the vast majority of chemotherapy-linked and immunotherapy-linked TC reactions have occurred during initial infusions. We also discuss the different mechanisms which link TC to immunotherapy and chemotherapy, and propose that there may be a potential for risk-stratifying recipients of this frequently used immunotherapy prior to administering treatment.

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May 12, 2017·Journal of Cardiovascular Pharmacology and Therapeutics·Kazuhiko Kido, Maya Guglin
Mar 30, 2016·Circulation·Joerg HerrmannKonstantinos Marmagkiolis
Mar 11, 2020·Cardio-Oncology·Aakash DesaiAgnes S Kim
May 10, 2020·BMJ Case Reports·Beatriz Cathala Esberard, Michael Mohseni
May 11, 2017·Journal of Renal Injury Prevention·Wisit CheungpasitpornFernando C Fervenza
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Feb 20, 2021·Current Opinion in Supportive and Palliative Care·Jiliu PanAlexander R Lyon
May 19, 2021·Journal of Cardiovascular Pharmacology·Andreina CarbonePaolo Golino

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