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BMC Cardiovasc Disord ; 19(1): 169, 2019 07 16.
Artigo em Inglês | MEDLINE | ID: mdl-31311496

RESUMO

BACKGROUND: Anthracyclines are highly effective anticancer medication prescribed for the treatment of breast cancer. Nevertheless, the use of anthracyclines as chemotherapeutic agents involves a risk for development of cardiac toxicity which may cause restrictive and dilated cardiomyopathy. Currently, genetic predisposition is not considered as a risk factor for cardiotoxicity associated to the use of anthracyclines. CASE PRESENTATION: We report the case of a 37-years old Panamanian female patient diagnosed with breast cancer who developed clinical signs of severe heart failure after treatment with doxorubicin. A diagnosis of anthracycline induced cardiomyopathy was made and treatment was initiated accordingly. A whole exome sequencing study performed to the patient showed the presence of a missense mutation in LMNA gene, which codifies for lamin A/C. Our results points to a correlation between the LMNA variant and the anthracycline cardiotoxicity developed by the woman. Improvement of the clinical symptoms and the left ventricle ejection fraction was observed after proper treatment. CONCLUSIONS: This case report suggests for the first time a potential genetic predisposition for anthracyclines induced cardiomyopathy in patients with mutations in LMNA gene. Perhaps chemotherapies accelerate or deliver the "second-hit" in the development of DCM in patients with genetic mutations. More data is needed to understand the contribution of LMNA variants that predispose to DCM in patients receiving cardiotoxic therapies.


Assuntos
Antibióticos Antineoplásicos/efeitos adversos , Neoplasias da Mama/tratamento farmacológico , Carcinoma Ductal de Mama/tratamento farmacológico , Cardiomiopatia Dilatada/induzido quimicamente , Cardiomiopatia Dilatada/genética , Doxorrubicina/efeitos adversos , Lamina Tipo A/genética , Mutação de Sentido Incorreto , Variantes Farmacogenômicos , Antagonistas Adrenérgicos beta/uso terapêutico , Adulto , Anti-Hipertensivos/uso terapêutico , Cardiomiopatia Dilatada/diagnóstico por imagem , Cardiomiopatia Dilatada/tratamento farmacológico , Cardiotoxicidade , Diuréticos/uso terapêutico , Feminino , Predisposição Genética para Doença , Humanos , Fatores de Risco , Resultado do Tratamento
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