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 atr...

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Bibliographic Details
Published inAmerican journal of therapeutics Vol. 11; no. 1; p. 77
Main Authors Daya, Samantapudi K, Gowda, Ramesh M, Khan, Ijaz A
Format Journal Article
LanguageEnglish
Published United States 01.01.2004
Subjects
Aged
Anti-Infective Agents - adverse effects
Anti-Infective Agents - therapeutic use
Ciprofloxacin - adverse effects
Ciprofloxacin - therapeutic use
Humans
Hypocalcemia - complications
Male
Renal Dialysis - adverse effects
Renal Insufficiency - therapy
Torsades de Pointes - chemically induced
Torsades de Pointes - etiology
Urinary Tract Infections - drug therapy
Urinary Tract Infections - etiology
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Summary: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.
ISSN:1075-2765
DOI:10.1097/00045391-200401000-00014