Abiraterone-induced refractory hypokalaemia and torsades de pointes in a patient with metastatic castration-resistant prostate carcinoma: a case report.

Autor:	Riad M; Internal Medicine Department, University of Alabama, Huntsville Regional Campus, Huntsville, AL 35801, USA., Allison JS; CardiologyDepartment, TheHeart Center, Huntsville Hospital, Huntsville, AL 35801, USA., Nayyal S; PharmacyDepartment, University of Colorado, Denver, Skaggs School of Pharmacy, Denver, CO 80045, USA., Hritani A; Internal Medicine Department, University of Alabama, Huntsville Regional Campus, Huntsville, AL 35801, USA.; CardiologyDepartment, TheHeart Center, Huntsville Hospital, Huntsville, AL 35801, USA.
Jazyk:	angličtina
Zdroj:	European heart journal. Case reports [Eur Heart J Case Rep] 2021 Nov 16; Vol. 5 (12), pp. ytab462. Date of Electronic Publication: 2021 Nov 16 (Print Publication: 2021).
DOI:	10.1093/ehjcr/ytab462
Abstrakt:	Background: Abiraterone, an androgen deprivation therapy, has been used in the treatment of metastatic castration-resistant prostate cancer (mCRPC). It has been associated with increased risks of hypokalaemia and cardiac disorders. We report a case of torsades de pointes (TdP) associated with abiraterone use and refractory hypokalaemia in a man with mCRPC. Case Summary: A 78-year-old man with mCRPC presented to the emergency room for generalized weakness. Laboratory results revealed a potassium level of 2.2 mmol/L (3.5-5.0), magnesium level of 2.4 mg/dL (1.6-2.5), and normal kidney and hepatic functions. Initial electrocardiogram showed atrial fibrillation with rapid ventricular rate of 106 b.p.m., frequent premature ventricular contractions, and a QTc of 634 ms. The patient had multiple episodes of TdP, became pulseless and underwent advanced cardiac life support, including defibrillation. Despite a total of 220 mEq of intravenous potassium chloride, his potassium level only improved to 2.8 mmol/L. He received spironolactone and amiloride to promote urinary potassium reabsorption in addition to hydrocortisone, in an effort to reduce abiraterone's effect on increasing mineralocorticoid synthesis. Discussion: Abiraterone has been widely used in mCRPC since its approval by the Food and Drug Adminstration in 2011. Regulatory guidelines and standardized close QTc and electrolyte monitoring in patients may help prevent fatal arrhythmias associated with abiraterone. (© The Author(s) 2021. Published by Oxford University Press on behalf of the European Society of Cardiology.)
Databáze:	MEDLINE
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