Abstract
We recently experienced a patient who developed stress cardiomyopathy during the course of chronic inflammatory demyelinating polyneuropathy (CIDP). The patient was a 56-year-old woman who developed CIDP at 45 years of age and experienced repeated exacerbation-remission cycles several times thereafter. The most recent CIDP occurrence caused left facial nerve paralysis and muscle weakness in both legs; therefore, she was admitted with a diagnosis of CIDP acute exacerbation. Respiratory muscle paralysis and limb paralysis occurred the day after she was admitted; she was put on a ventilator in the ICU, and intravenous immunoglobulin therapy was administered. After admission to the ICU, the patient's hemodynamics varied greatly. On day 3 after ICU admission, an echocardiogram showed wall motion abnormalities. The base of her heart showed normal contractions but akinesis at the apex, leading to the diagnosis of stress cardiomyopathy. She also had a fever higher than 40°C. Wall motion abnormality was improved by the seventh day after ICU admission, and her limb paralysis and fever also improved. Unlike in Guillain-Barré syndrome, which is related to CIDP, severe autonomic neuropathy in CIDP is rare. We speculate that severe autonomic neuropathy might have been a cause of takotsubo cardiomyopathy in this case.
