Torsades de pointes upon fluconazole administration in a patient with acute myeloblastic leukemia

Prolonged QT syndrome often causes torsades de pointes (Tdp), a potentially lethal arrhythmia. A 55‐year‐old woman with M4Eo who was receiving consolidation chemotherapy had an episode of prolonged QT and Tdp following fluconazole (FCZ) administration. Intravenous supplementation of magnesium sulfat...

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Bibliographic Details
Published in:American journal of hematology 2006-05, Vol.81 (5), p.366-369
Main Authors: Tatetsu, Hiro, Asou, Norio, Nakamura, Miki, Hanaoka, Nobuyoshi, Matsuno, Fumihiko, Horikawa, Kentaro, Mitsuya, Hiroaki
Format: Article
Language:English
Subjects:
acute leukemia
Antifungal Agents - administration & dosage
Antifungal Agents - adverse effects
Antifungal Agents - therapeutic use
Antineoplastic Combined Chemotherapy Protocols - therapeutic use
Biological and medical sciences
Cardiac dysrhythmias
Cardiology. Vascular system
Female
fluconazole
Fluconazole - administration & dosage
Fluconazole - adverse effects
Fluconazole - therapeutic use
Heart
Hematologic and hematopoietic diseases
Humans
Leukemia, Myeloid, Acute - complications
Leukemia, Myeloid, Acute - drug therapy
Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis
Medical sciences
Middle Aged
Mycoses - complications
Mycoses - drug therapy
Opportunistic Infections - complications
Opportunistic Infections - drug therapy
QT prolongation
torsades de pointes
Torsades de Pointes - chemically induced
Treatment Outcome
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Summary:Prolonged QT syndrome often causes torsades de pointes (Tdp), a potentially lethal arrhythmia. A 55‐year‐old woman with M4Eo who was receiving consolidation chemotherapy had an episode of prolonged QT and Tdp following fluconazole (FCZ) administration. Intravenous supplementation of magnesium sulfate and multiple attempts at electrocardioversion led to recovery from the arrhythmia. FCZ appears to contribute to the development of QT prolongation, in particular with low concentrations of serum potassium or magnesium. Although mechanisms of Tdp development in patients with QT prolongation remain to be determined, it is possible that FCZ administration leads to manifestation of Tdp. Special cautions should be exercised upon the emergence of QT prolongation following FCZ administration. Am. J. Hematol. 81:366–369, 2006. © 2006 Wiley‐Liss, Inc.
ISSN:0361-8609
1096-8652
DOI:10.1002/ajh.20557