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

✍ Scribed by Hiro Tatetsu; Norio Asou; Miki Nakamura; Nobuyoshi Hanaoka; Fumihiko Matsuno; Kentaro Horikawa; Hiroaki Mitsuya

Publisher
John Wiley and Sons
Year
2006
Tongue
English
Weight
150 KB
Volume
81
Category
Article
ISSN
0361-8609

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✦ Synopsis

Abstract

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. Β© 2006 Wiley‐Liss, Inc.

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