Ciprofloxacin- and hypocalcemia-induced torsade de pointes triggered by hemodialysis.
Torsade de pointes is a polymorphic form of ventricular tachycardia associated with prolongation of the QT interval, which may be either congenital or acquired. Etiologies for the acquired forms include drug effects, hypokalemia, hypomagnesemia, hypocalcemia, starvation, sick sinus syndrome, and atrioventricular block. We present a 76-year-old man with acute on chronic renal failure, hypocalcemia, on ciprofloxacin, and a prolonged QT interval with torsade de pointes triggered by hemodialysis. The QT prolongation was corrected by treating the hypocalcemia. Hypocalcemia and ciprofloxacin are known to independently cause prolonged QT interval and torsade de pointes; our case illustrates that dialysis can trigger torsade on a background of this risk factor combination.
Daya
Samantapudi K
SK
Department of Medicine, York Hospital, York, Pennsylvania, USA.
Gowda
Ramesh M
RM
Khan
Ijaz A
IA
D000368:Aged; D000890:Anti-Infective Agents / Q000009:adverse effects* / Q000627:therapeutic use; D002939:Ciprofloxacin / Q000009:adverse effects* / Q000627:therapeutic use; D006801:Humans; D006996:Hypocalcemia / Q000150:complications*; D008297:Male; D006435:Renal Dialysis / Q000009:adverse effects; D051437:Renal Insufficiency / Q000628:therapy; D016171:Torsades de Pointes / Q000139:chemically induced / Q000209:etiology*; D014552:Urinary Tract Infections / Q000188:drug therapy / Q000209:etiology
D000890:Anti-Infective Agents; D002939:Ciprofloxacin