Reactions 1664, p14 - 12 Aug 2017 Torsades de pointes secondary to hypokalaemia: case report A 77-year-old man developed torsades de pointes secondary to hypokalaemia during treatment with abiraterone for metastatic prostate cancer. The man, who had a history of ischaemic heart disease (IHD), atrial fibrillation and coronary artery bypass grafting (CABG), was hospitalised after a syncopal event. He had been receiving abiraterone 250mg four times a day [route of administration not stated] for six months and prednisone. At admission, he had a HR of 70 beats/min and BP of 15/85mm Hg. An ECG revealed a prolonged corrected QT interval (QTc) of 650ms. He had three episodes of TdP which caused syncope. His serum electrolyte level was within normal limit. He had four more episodes of TdP, which required defibrillation, and also several episodes of non-sustained TdP. The The man was treated with isoprenaline to increase his HR and decrease QT interval. Isoprenaline was tapered off on hospital day 2. After receiving 160 mmoL of potassium, his QTc interval significantly improved. A transthoracic echocardiogram revealed mild left ventricular abnormality. Abiraterone was stopped and he was subsequently discharged in a stable condition. At discharge, his QTc was 460ms which remained same at one month follow-up. A diagnosis of TdP secondary to abiraterone-induced hypokalaemia was made at discharge. Naranjo probability score of 7 indicated a probable attribution of hypokalaemia to abiraterone treatment. Author comment: "We present a case of a 77 year-old gentleman with previous coronary artery bypass grafting, admitted to hospital with recurrent torsades de pointes (TdP) due to abiraterone-induced hypokalaemia and prolonged QTc." Khan A, et al. Life threatening torsades de pointes due to abiraterone-induced hypokaelemia in a patient with metastatic prostate cancer. New Zealand Medical Journal 129: 124-127, No. 1445, 18 Nov 2016. Available from: URL: http:// www.nzma.org.nz/journal/read-the-journal/all-issues/2010-2019/2016/ vol-129-no-1445-18-november-2016/7073 - New Zealand 803262452 0114-9954/17/1664-0001/$14.95 Adis © 2017 Springer International Publishing AG. All rights reserved Reactions 12 Aug 2017 No. 1664
Reactions Weekly – Springer Journals
Published: Aug 12, 2017
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