title: Adrenal insufficiency causes life-threatening arrhythmia with prolongation of QT interval.
abstract: A 63-year-old woman who had hypopituitarism was re-admitted to our hospital because of fever, diarrhea and disturbance of consciousness with life-threatening arrhythmia due to prolongation of the QT interval. She has been treated with hydrocortisone consequently, and has shown few ventricular arrhythmias with normalization of the QT interval. There have been several reports showing the case of prolonged QT interval with adrenal insufficiency, but there are few reports of isolated adrenocorticotropic hormone deficiency without any electrolytes imbalance that showed polymorphic ventricular tachycardia associated with QT prolongation. We discuss some possible mechanisms of how adrenal insufficiency causes life-threatening arrhythmia. Since lack of glucocorticoid hormone might induce prolongation of the QT interval, patients with adrenal insufficiency should be paid attention as candidates of lethal arrhythmias particularly when exposed to excessive stresses.
authors.affiliation: Department of Cardiology, Tokyo Metropolitan Police Hospital, 4-22-1 Nakano-ku, Nakano, Tokyo, 164-8541, Japan. sieg_erringen@yahoo.co.jp.
authors.forename: Jin
authors.initials: J
authors.lastname: Komuro
authors.affiliation: Department of Cardiology, Tokyo Metropolitan Police Hospital, 4-22-1 Nakano-ku, Nakano, Tokyo, 164-8541, Japan.
authors.forename: Mitsunobu
authors.initials: M
authors.lastname: Kaneko
authors.affiliation: Department of Cardiology, Tokyo Metropolitan Police Hospital, 4-22-1 Nakano-ku, Nakano, Tokyo, 164-8541, Japan.
authors.forename: Kazutaka
authors.initials: K
authors.lastname: Ueda
authors.affiliation: Department of Cardiology, Tokyo Metropolitan Police Hospital, 4-22-1 Nakano-ku, Nakano, Tokyo, 164-8541, Japan.
authors.forename: Shuya
authors.initials: S
authors.lastname: Nitta
authors.affiliation: Department of Cardiology, Tokyo Metropolitan Police Hospital, 4-22-1 Nakano-ku, Nakano, Tokyo, 164-8541, Japan.
authors.forename: Masashi
authors.initials: M
authors.lastname: Kasao
authors.affiliation: Department of Cardiology, Tokyo Metropolitan Police Hospital, 4-22-1 Nakano-ku, Nakano, Tokyo, 164-8541, Japan.
authors.forename: Tetsuro
authors.initials: T
authors.lastname: Shirai
mesh_terms: D000200:Action Potentials; D000309:Adrenal Insufficiency / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D004562:Electrocardiography; D005260:Female; D006329:Heart Conduction System / Q000503:physiopathology*; D006339:Heart Rate; D006801:Humans; D007018:Hypopituitarism / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D008133:Long QT Syndrome / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy; D008875:Middle Aged; D017180:Tachycardia, Ventricular / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy; D016896:Treatment Outcome
keywords: Adrenal crisis; Hypopituitarism; Long-QT syndrome; Polymorphic ventricular tachycardia; Serum- and glucocorticoid-inducible kinase (SGK1)