Key result
Steroid replacement therapy improved electrocardiographic changes and reduced the corrected QT interval from 670 msec to 540 msec in a patient with adrenal insufficiency.
Why the study?
Does steroid replacement therapy improve QT prolongation in a patient with adrenal insufficiency?
Case Report (n=1)
No
Does steroid replacement therapy improve QT prolongation in a patient with adrenal insufficiency?
Adrenal insufficiency should be considered as a potential, reversible cause of severe QT prolongation and Torsades de Pointes.
Answers are grounded in this paper and cite their sources.
May shorten QTc in adrenal insufficiency; hypothesis-generating and requires prospective confirmation.
QT prolongation and Torsades de Pointes were observed in a 44-year-old woman who had adrenal insufficiency caused by isolated adrenocorticotropic hormone deficiency. Although she had several risk factors for QT prolongation, we concluded that the adrenal insufficiency contributed to the QT prolongation, because the electrocardiographic changes were improved after steroid replacement therapy. It is known that the QT interval in a patient with adrenal insufficiency tends to be extended. However, reports on adrenal insufficiency in which the QT interval was sufficiently prolonged to cause Torsades de Pointes are rare. Clinicians should consider the possibility of adrenal insufficiency in patients with QT prolongation.
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Kanamori et al. (2014) conducted a case report in Long QT Syndrome and Adrenal Insufficiency (n=1). Steroid replacement therapy was evaluated on Corrected QT interval (QTc). Steroid replacement therapy improved electrocardiographic changes and reduced the corrected QT interval from 670 msec to 540 msec in a patient with adrenal insufficiency.
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