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 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.
Tatetsu
Hiro
H
Department of Hematology, Kumamoto University School of Medicine, Kumamoto, Japan.
Asou
Norio
N
Nakamura
Miki
M
Hanaoka
Nobuyoshi
N
Matsuno
Fumihiko
F
Horikawa
Kentaro
K
Mitsuya
Hiroaki
H
D000935:Antifungal Agents / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D005260:Female; D015725:Fluconazole / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000150:complications* / Q000188:drug therapy; D008875:Middle Aged; D009181:Mycoses / Q000150:complications / Q000188:drug therapy*; D009894:Opportunistic Infections / Q000150:complications / Q000188:drug therapy*; D016171:Torsades de Pointes / Q000139:chemically induced*; D016896:Treatment Outcome
D000935:Antifungal Agents; D015725:Fluconazole