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Sodium stibogluconate and polymorphic ventricular tachycardia.

Arun K Baranwal1, Ravi N Mandal, Rupa Singh

  • 1Department of Pediatrics, B. P. Koirala Institute of Health Sciences, Dharan, India. Baranwal1970@ yahoo.com

Indian Journal of Pediatrics
|April 7, 2005
PubMed
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Pentavalent antimonials, like sodium stibogluconate, can prolong the QT-interval, leading to dangerous ventricular tachycardia. This case highlights a rare instance of Torsades de Pointes in a child treated for visceral leishmaniasis.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Pharmacology

Background:

  • Pentavalent antimonials are standard treatments for visceral leishmaniasis.
  • Antimicrobials, including antimonials, are known to potentially cause QT-interval prolongation and ventricular arrhythmias.
  • Torsades de Pointes (TdP) is a specific type of polymorphic ventricular tachycardia associated with QT prolongation.

Observation:

  • A 12-year-old girl with visceral leishmaniasis received a 30-day course of sodium stibogluconate.
  • Following treatment, the patient experienced syncopal attacks.
  • Electrocardiogram revealed a significantly prolonged QT-interval and polymorphic ventricular tachycardia consistent with Torsades de Pointes.

Findings:

  • Sodium stibogluconate administration was temporally associated with the development of life-threatening cardiac arrhythmias.

Related Experiment Videos

  • This case represents a rare documented instance of Torsades de Pointes induced by sodium stibogluconate.
  • The patient's cardiac events were successfully managed with lidocaine infusion and cardioversion.

    • Implications:

    • Clinicians should be vigilant for cardiac side effects, including QT prolongation and TdP, in patients treated with sodium stibogluconate.
    • This case underscores the importance of cardiac monitoring during antimonial therapy, especially in pediatric patients.
    • Further research into the electrophysiological effects of pentavalent antimonials may be warranted to optimize treatment protocols and patient safety.