College of Medicine, King Saud bin Abdulaziz University for Health Sciences College of Medicine, Riyadh, Al Riyadh Province, Saudi Arabia
Department of Medicine, King Abdulaziz Medical City, Riyadh, Al Riyadh Province, Saudi Arabia.
BMJ Case Rep. 2022 Apr 26;15(4):e246175. doi: 10.1136/bcr-2021-246175.
Congenital chloride losing diarrhoea (CCLD) is a rare disease caused by mutations in an intestinal chloride/bicarbonate ion exchange channel. Few reports describe CCLD in adults and none has described the impact of a parasitic infection on CCLD. Severe diarrhoea may result in hypokalaemia with QT interval prolongation. Treatment with antiemetics may further increase the QT interval. To raise awareness of this preventable complication, we describe the course of a woman in her 20s with CCLD who developed COVID-19 and a infestation. Treatment with antiemetics and hypokalaemia resulted in prolongation of the QT interval to 640 ms. While, the QT interval normalised with discontinuation of antiemetics and electrolyte replacement, patients with CCLD must take precautions to prevent gastrointestinal infections. Regardless, whenever patients with CCLD present to hospital, the authors recommend monitoring the QT interval and avoiding medications that predispose to torsade de pointes.
先天性氯离子腹泻（CCLD）是一种由肠道氯离子/碳酸氢根离子交换通道突变引起的罕见疾病。很少有报告描述成人 CCLD，也没有报告描述寄生虫感染对 CCLD 的影响。严重腹泻可能导致低钾血症和 QT 间期延长。止吐药的治疗可能会进一步增加 QT 间期。为了提高对这种可预防并发症的认识，我们描述了一位 20 多岁患有 CCLD 的女性的病程，她感染了 COVID-19 和寄生虫。止吐药和低钾血症的治疗导致 QT 间期延长至 640ms。虽然，QT 间期随着止吐药和电解质替代的停用而恢复正常，但 CCLD 患者必须采取预防胃肠道感染的措施。无论如何，只要 CCLD 患者到医院就诊，作者建议监测 QT 间期并避免使用易引起尖端扭转型室性心动过速的药物。
