Alcoholic liver cirrhosis complicated with torsade de pointes during plasma exchange and hemodiafiltration.
A 36-year-old man with severe alcoholic hepatitis was treated with plasma exchange combined with hemodiafiltration to remove endotoxins and inflammatory cytokines. During the treatment, he had critical arrhythmia (torsade de pointes [TdP]). His laboratory data showed hypomagnesemia, which was suspected to be responsible for the development of TdP. Patients with alcoholic liver disease tend to have hypomagnesemia and Q-T interval prolongation. Furthermore, hemodiafiltration may cause hypomagnesemia. Careful observation for electrolytic imbalance is necessary when clinicians treat patients with alcoholic liver failure with a liver support system.
Nakasone
H
H
First Department of Internal Medicine, Faculty of Medicine, University of the Ryukyus, Okinawa, Japan.
Sugama
R
R
Sakugawa
H
H
Matayoshi
R
R
Miyagi
T
T
Maeshiro
T
T
Yamashiro
T
T
Higa
F
F
Hokama
A
A
Kinjo
F
F
Saito
A
A
Toda
T
T
D000328:Adult; D004562:Electrocardiography / Q000379:methods; D017583:Hemodiafiltration / Q000009:adverse effects*; D006801:Humans; D008104:Liver Cirrhosis, Alcoholic / Q000097:blood / Q000150:complications / Q000628:therapy*; D008274:Magnesium / Q000097:blood*; D008297:Male; D010951:Plasma Exchange / Q000009:adverse effects*; D016171:Torsades de Pointes / Q000097:blood / Q000175:diagnosis / Q000209:etiology*
D008274:Magnesium