Key result
Administration of steroid and thyroid hormones normalized QTc prolongation and T wave inversion, and prevented recurrence of torsades de pointes in a patient with panhypopituitarism.
Why the study?
Does hormone replacement therapy resolve acquired long QT syndrome and Torsades de Pointes in a patient with panhypopituitarism?
Case Report (n=1)
Does hormone replacement therapy resolve acquired long QT syndrome and Torsades de Pointes in a patient with panhypopituitarism?
Answers are grounded in this paper and cite their sources.
Hormonal disorders such as panhypopituitarism should be considered as a cause of polymorphic ventricular tachycardia with long QT intervals, which can be reversed with appropriate hormone supplementation.
We describe a 64-year-old male patient with panhypopituitarism who experienced polymorphic ventricular tachycardia (VT) associated with long QT intervals. The panhypopituitarism developed as a sequelae of radiation therapy administered 20 years prior to his current presentation and was recently aggravated by urinary tract infection with sepsis. In this case, polymorphic VT was resistant to conventional therapy (including magnesium infusion), and QT prolongation and T wave inversion were normalized after the administration of steroid and thyroid hormones. Thyroid hormone is generally known to be associated with torsades de pointes (TdP), but steroid or other hormones may also provoke TdP. Hormonal disorders should be considered as a cause of polymorphic VT with long QT intervals. Some arrhythmias can be life-threatening, and they can be prevented with supplementation of the insufficient hormone.
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Kang et al. (2013) conducted a case report in Acquired Long QT Syndrome with Torsades de Pointes and Panhypopituitarism (n=1). Hormone replacement therapy (steroid, thyroid hormone, and desmopressin) was evaluated on QTc interval and T wave inversion. Administration of steroid and thyroid hormones normalized QTc prolongation and T wave inversion, and prevented recurrence of torsades de pointes in a patient with panhypopituitarism.
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