Torsades de Pointes Ventricular Tachycardia in a Pediatric Patient Treated with Fluconazole
Fluconazole is an antifungal medication that has been reported to cause prolongation of the QT interval and Torsades de Pointes (TdP) ventricular tachycardia in adults. We describe the case of an 11-year-old child treated with Fluconazole who developed ventricular arrhythmia culminating in TdP. We d...
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| Published in | Pediatric cardiology Vol. 29; no. 1; pp. 210 - 213 |
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| Main Authors | , |
| Format | Journal Article |
| Language | English |
| Published |
New York
Springer-Verlag
2008
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| Subjects | |
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| Abstract | Fluconazole is an antifungal medication that has been reported to cause prolongation of the QT interval and Torsades de Pointes (TdP) ventricular tachycardia in adults. We describe the case of an 11-year-old child treated with Fluconazole who developed ventricular arrhythmia culminating in TdP. We discuss the possible roles played by genetic and environmental factors in this child’s rhythm disturbances. After briefly summarizing similar cases from the adult literature, we outline the putative mechanism by which Fluconazole may cause arrhythmia. This case should alert pediatricians to the possible risks of Fluconazole use, especially in the presence of electrolyte abnormalities, diuretic use, therapy with other pro-arrhythmic agents, or suspicion of congenital Long-QT Syndrome. |
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| AbstractList | Fluconazole is an antifungal medication that has been reported to cause prolongation of the QT interval and Torsades de Pointes (TdP) ventricular tachycardia in adults. We describe the case of an 11-year-old child treated with fluconazole who developed ventricular arrhythmia culminating in TdP. We discuss the possible roles played by genetic and environmental factors in this child's rhythm disturbances. After briefly summarizing similar cases from the adult literature, we outline the putative mechanism by which fluconazole may cause arrhythmia. This case should alert pediatricians to the possible risks of fluconazole use, especially in the presence of electrolyte abnormalities, diuretic use, therapy with other pro-arrhythmic agents, or suspicion of congenital Long-QT Syndrome. |
| Author | Kantoch, Michal J. Esch, Jesse J. |
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| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/17849073$$D View this record in MEDLINE/PubMed |
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| Cites_doi | 10.1592/phco.22.17.1632.34129 10.1046/j.1365-2125.2000.00163.x 10.1002/ajh.20557 10.1345/aph.10210 10.1016/S0735-6757(00)90027-5 10.1038/sj.bjp.0706095 10.1016/j.febslet.2006.02.073 10.1161/01.CIR.0000014448.19052.4C 10.1093/ajhp/60.23.2479 10.7326/0003-4819-131-10-199911160-00034 10.1161/01.CIR.102.10.1178 10.1161/01.CIR.99.4.529 |
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| References_xml | – volume: 22 start-page: 1632 year: 2002 end-page: 1637 ident: CR3 article-title: Probable case of torsades de pointes induced by fluconazole publication-title: Pharmacotherapy doi: 10.1592/phco.22.17.1632.34129 contributor: fullname: Mathis – volume: 49 start-page: 373 year: 2000 end-page: 378 ident: CR5 article-title: Dramatic inhibition of amiodarone metabolism induced by grapefruit juice publication-title: Br J Clin Pharmacol doi: 10.1046/j.1365-2125.2000.00163.x contributor: fullname: Lhermitte – volume: 81 start-page: 366 year: 2006 end-page: 369 ident: CR9 article-title: Torsades de pointes upon fluconazole administration in a patient with acute myeloblastic anemia publication-title: Am J Hematol doi: 10.1002/ajh.20557 contributor: fullname: Mitsuya – volume: 35 start-page: 432 year: 2001 end-page: 434 ident: CR10 article-title: Fluconazole-induced torsade de pointes publication-title: Ann Pharmacother doi: 10.1345/aph.10210 contributor: fullname: Merliss – volume: 99 start-page: 529 year: 1999 end-page: 533 ident: CR6 article-title: Low penetrance in the long-QT syndrome publication-title: Circulation contributor: fullname: Schwartz – volume: 18 start-page: 227 year: 2000 end-page: 229 ident: CR1 article-title: Prolonged QT interval and torsades de pointes caused by the combination of fluconazole and amitriptyline publication-title: Am J Emerg Med doi: 10.1016/S0735-6757(00)90027-5 contributor: fullname: Biblo – volume: 60 start-page: 2479 year: 2003 end-page: 2483 ident: CR2 article-title: Fluconazole- and levofloxacin-induced torsades de pointes in an intensive care unit patient publication-title: Am J Health Syst Pharm contributor: fullname: Ramaswamy – volume: 144 start-page: 840 year: 2005 end-page: 848 ident: CR4 article-title: Blockade of HERG cardiac K current by antifungal drug miconazole publication-title: Br J Pharmacol doi: 10.1038/sj.bjp.0706095 contributor: fullname: Nakashima – volume: 580 start-page: 1999 year: 2006 end-page: 2005 ident: CR7 article-title: Inhibition of HERG K channel by the antifungal drug ketoconazole depends on channel gating and involves the S6 residue F656 publication-title: FEBS Lett doi: 10.1016/j.febslet.2006.02.073 contributor: fullname: Hancox – volume: 102 start-page: 1178 year: 2000 end-page: 1185 ident: CR8 article-title: Spectrum of mutations in long-QT syndrome genes publication-title: Circulation contributor: fullname: Keating – volume: 131 start-page: 797 year: 1999 ident: CR11 article-title: Long QT syndrome and torsade de pointes in a patient receiving fluconazole publication-title: Ann Intern Med contributor: fullname: Bohm – volume: 105 start-page: 1943 year: 2002 end-page: 1948 ident: CR12 article-title: Allelic variants in long-QT diseae genes in patients with drug-associated Torsades de Pointes publication-title: Circulation doi: 10.1161/01.CIR.0000014448.19052.4C contributor: fullname: Roden – volume: 81 start-page: 366 year: 2006 ident: 9076_CR9 publication-title: Am J Hematol doi: 10.1002/ajh.20557 contributor: fullname: H Tatetsu – volume: 35 start-page: 432 year: 2001 ident: 9076_CR10 publication-title: Ann Pharmacother doi: 10.1345/aph.10210 contributor: fullname: VN Tholakanhalli – volume: 60 start-page: 2479 year: 2003 ident: 9076_CR2 publication-title: Am J Health Syst Pharm doi: 10.1093/ajhp/60.23.2479 contributor: fullname: PJ Gandhi – volume: 105 start-page: 1943 year: 2002 ident: 9076_CR12 publication-title: Circulation doi: 10.1161/01.CIR.0000014448.19052.4C contributor: fullname: P Yang – volume: 144 start-page: 840 year: 2005 ident: 9076_CR4 publication-title: Br J Pharmacol doi: 10.1038/sj.bjp.0706095 contributor: fullname: K Kikuchi – volume: 49 start-page: 373 year: 2000 ident: 9076_CR5 publication-title: Br J Clin Pharmacol doi: 10.1046/j.1365-2125.2000.00163.x contributor: fullname: CC Libersa – volume: 131 start-page: 797 year: 1999 ident: 9076_CR11 publication-title: Ann Intern Med doi: 10.7326/0003-4819-131-10-199911160-00034 contributor: fullname: S Wassman – volume: 22 start-page: 1632 year: 2002 ident: 9076_CR3 publication-title: Pharmacotherapy doi: 10.1592/phco.22.17.1632.34129 contributor: fullname: M Khazan – volume: 18 start-page: 227 year: 2000 ident: 9076_CR1 publication-title: Am J Emerg Med doi: 10.1016/S0735-6757(00)90027-5 contributor: fullname: ST Dorsey – volume: 102 start-page: 1178 year: 2000 ident: 9076_CR8 publication-title: Circulation doi: 10.1161/01.CIR.102.10.1178 contributor: fullname: I Splawski – volume: 99 start-page: 529 year: 1999 ident: 9076_CR6 publication-title: Circulation doi: 10.1161/01.CIR.99.4.529 contributor: fullname: SG Priori – volume: 580 start-page: 1999 year: 2006 ident: 9076_CR7 publication-title: FEBS Lett doi: 10.1016/j.febslet.2006.02.073 contributor: fullname: JM Ridley |
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| SubjectTerms | Antifungal Agents - adverse effects Antifungal Agents - pharmacology Antifungal Agents - therapeutic use Candidiasis - drug therapy Cardiac Surgery Cardiology Case Report Child Electrocardiography Fluconazole - adverse effects Fluconazole - pharmacology Fluconazole - therapeutic use Heart Conduction System - drug effects Humans Male Medicine Medicine & Public Health Shock, Septic - drug therapy Shock, Septic - microbiology Torsades de Pointes - chemically induced Vascular Surgery |
| Title | Torsades de Pointes Ventricular Tachycardia in a Pediatric Patient Treated with Fluconazole |
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