The perfect storm: Torsades de Pointes in a child with leukemia.
Torsades de Pointes (TdP) is a life-threatening ventricular arrhythmia that can be associated with metabolic abnormalities, exposure to arrhythmogenic medications, and congenital long-QT syndrome. This report describes a patient with ALL and multiple complications of therapy who developed TdP. The patient had no evidence of congenital long-QT syndrome, but a constellation of factors appears to have led to QT prolongation, ventricular ectopy, and TdP. Although the patient suffered cardiac arrest, rapid recognition of TdP and prompt defibrillation resulted in an excellent outcome.
Bagatell
Rochelle
R
Department of Pediatrics, Section of Pediatric Hematology/Oncology, University of Arizona Health Sciences Center, Tucson, Arizona 85724, USA. bagatell@peds.arizona.edu
Hainstock
Michael
M
Lowe
Merlin C
MC
Barber
Brent J
BJ
Samson
Ricardo A
RA
D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000009:adverse effects; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000009:adverse effects; D016887:Cardiopulmonary Resuscitation; D004473:Ecthyma / Q000175:diagnosis / Q000188:drug therapy; D004562:Electrocardiography; D004573:Electrolytes / Q000008:administration & dosage / Q000097:blood; D005260:Female; D005500:Follow-Up Studies; D006323:Heart Arrest / Q000209:etiology / Q000628:therapy; D006801:Humans; D007674:Kidney Diseases / Q000139:chemically induced / Q000628:therapy; D008133:Long QT Syndrome / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D012074:Remission Induction; D016171:Torsades de Pointes / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D016896:Treatment Outcome; D018879:Ventricular Premature Complexes / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy
D000900:Anti-Bacterial Agents; D004573:Electrolytes