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A Case of Diffuse Panbronchiolitis Complicated with Takotsubo Cardiomyopathy Zen Isobe 1,2 , Tomohiro Aizawa 1 , Hiroaki Masubuchi 1 , Masao Takemura 1 , Masahiko Kanbe 1 , Manabu Ueno 1 , Tatsuo Suga 1 , Toshitaka Maeno 1 , Masahiko Kurabayashi 1 1Department of Respiratory Medicine, Gunma University School of Medicine 2Isobe Clinic Keyword: たこつぼ心筋障害 , びまん性汎細気管支炎 , takotsubo cardiomyopathy , diffuse panbronchiolitis(DPB) pp.786-791
Published Date 2013/8/15
DOI https://doi.org/10.11477/mf.1404102286
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 A 54 year-old woman was admitted with dyspnea and loss of consciousness. In addition, she had severe hypercapnic respiratory failure. A chest radiograph on admission indicated the presence of butterfly shadows and cardiomegaly. An electrocardiography(ECG)performed on the day of admission showed ST elevation in leads Ⅰ and aVL, whereas an ECG performed on the 4th hospital day showed negative T waves and QT interval prolongation in leads V2 to V6. Coronary arteries appeared normal on coronary angiography. However, left ventriculography showed an asynergy of apical akinesis and basal hyperkinesis. Thus, we diagnosed the condition as takotsubo cardiomyopathy with congestive heart failure. The patient was treated in the intensive care unit, and although the heart failure improved, she continued to exhibit moderate hypoxemia. Chest computed tomography scans showed diffuse centrilobular small nodular shadows in both lung fields. In addition, a pulmonary function test showed marked obstructive impairment. We diagnosed this condition as diffuse panbronchiolitis(DPB)based on physical examination findings, a positive cold agglutinin reaction, and radiological findings as well as the presence of sinusitis and obstructive pulmonary impairment. Long-term chemotherapy with erythromycin was administered leading to an improvement of hypoxia. Thus, we report a rare case of takotsubo cardiomyopathy occurring in the acute exacerbation period of DPB.


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電子版ISSN 1882-1200 印刷版ISSN 0452-3458 医学書院

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