Kanamori Kenta, Yamashita Risa, Tsutsui Kenta, Hara Masumi, Murakawa Yuji
The Fourth Department of Internal Medicine, Teikyo University School of Medicine University Hospital, Japan.
Intern Med. 2014;53(20):2329-31. doi: 10.2169/internalmedicine.53.2726. Epub 2014 Oct 15.
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.
在一名因孤立性促肾上腺皮质激素缺乏导致肾上腺功能不全的44岁女性中观察到QT间期延长和尖端扭转型室速。尽管她有几个QT间期延长的危险因素,但我们得出结论,肾上腺功能不全导致了QT间期延长,因为在进行类固醇替代治疗后心电图改变有所改善。已知肾上腺功能不全患者的QT间期往往会延长。然而,关于QT间期延长到足以引起尖端扭转型室速的肾上腺功能不全的报道很少。临床医生应考虑QT间期延长患者存在肾上腺功能不全的可能性。