Vol.53 No.7 July 2005

Long QT syndrome followed by torasades de pointes due to fluconazole in remission induction chemotherapy for acute myelogenous leukemia

Kazuhiko Natori, Haruka Izumi, Shinya Okuda, Susumu Ishihara, Daisuke Nagase, Yoshinori Fujimoto, Yasuyuki Sugasawa, Chiaki Arai, Motohiro Kato, Masanori Umeda and Yasunobu Kuraishi

Division of Hematology and Oncology, Department of Internal Medicine, Toho University School of Medicine, 5-21-16 Omori-nishi, Ota-ku, Tokyo, JAPAN

Abstract

A 48-year-old man diagnosed with acute myeloid leukemia in November 1999 and undergoing bone marrow suppression after remission induction chemotherapy suffered fungal pneumonia treated with anti fungal fluconazole (FLCZ). On day 14 of the anti fungal treatment, he suffering from torsades de points, evidenced by a typical ECG pattern sign curve, was compatible with torasades de points. He felt palpitations and unclear conciousness and we found prolonged QT time on ECG and low serum Ca, QTtimenormalized when was FLCZ discontinued and was serum Ca was corrected. This very rare disorder is potentially fatal, and long QT time syndrome should be considered in pastients being treated with FLCZ for fungal infection.

Key word

fluconazole, torasades de pointes, acute myelogenous leukemia, QT-prolongation

Received

January 20, 2005

Accepted

May 17, 2005

Jpn. J. Chemother. 53 (7): 412-416, 2005