Um caso de arritmia supraventricular induzida por tacrolimus, após o transplante renal

Kim, Bo-Ra; Shin, Ho-Sik; Jung, Yeon-Soon; Rim, Hark

doi:10.1590/1516-3180.2013.1313472

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Sao Paulo Medical Journal

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Sumário

Case Report • São Paulo Med J. 131 (3) • 2013 • https://doi.org/10.1590/1516-3180.2013.1313472 copiar

Um caso de arritmia supraventricular induzida por tacrolimus, após o transplante renal

Autoria SCIMAGO INSTITUTIONS RANKINGS

CONTEXTO

Tacrolimus (tacrolimo) é uma potente droga imunossupressora frequentemente administrada a pacientes receptores de transplante e exibe uma variedade de efeitos cardiovasculares adversos.

RELATO DE CASO

Relatamos um caso de uma mulher asiática de 53 anos de idade que desenvolveu vários fenômenos de arritmias, incluindo complexos atriais prematuros e taquicardia supraventricular após a administração de tacrolimus.

CONCLUSÃO

Tacrolimus associado a arritmia após transplante de rim pode ser fatal, por isso, pacientes submetidos a esse procedimento devem ser cuidadosamente monitorados.

Tacrolimo; Arritimias cardíacas; Transplante de rim; Taquicardia supraventricular; Complexos atriais prematuros

Day	QT	QTc	Potassium (mEq/l)	Calcium (mg/dl)	Tacrolimus concentration (ng/ml)
Pre-op	442	493	4.5	9.0
POD 1	404	526	4.4	8.1
POD 2	376	487	4.7	8.4	10.6
POD 3	400	500	4.5	8.6	8.8
POD 4	396	469	4.4	9.1	17.6

Data base	Search strategy	Results
PubMed	“Tacrolimus” AND “arrhythmia”	4 case reports¹1. Johnson MC, So S, Marsh JW, Murphy AM. QT prolongation and Torsades de Pointes after administration of FK506. Transplantation. 1992;53(4):929-30.−⁴4. Nishimura M, Kim K, Uchiyama A, et al. Tacrolimus-induced life-threatening arrhythmia in a pediatric liver-transplant patient. Intensive Care Med. 2002;28(11):1683-4. 1 review of the literature⁵5. Marcassi AP, Yasbek DC, Pestana JO, et al. Ventricular arrhythmia in incident kidney transplant recipients: prevalence and associated factors. Transpl Int. 2011;24(1):67-72.
Embase	“Tacrolimus” AND “arrhythmia”	4 case reports¹1. Johnson MC, So S, Marsh JW, Murphy AM. QT prolongation and Torsades de Pointes after administration of FK506. Transplantation. 1992;53(4):929-30.−⁴4. Nishimura M, Kim K, Uchiyama A, et al. Tacrolimus-induced life-threatening arrhythmia in a pediatric liver-transplant patient. Intensive Care Med. 2002;28(11):1683-4. 1 review of the literature⁵5. Marcassi AP, Yasbek DC, Pestana JO, et al. Ventricular arrhythmia in incident kidney transplant recipients: prevalence and associated factors. Transpl Int. 2011;24(1):67-72.
Lilacs	“Tacrolimus” AND “arrhythmia”	4 case reports¹1. Johnson MC, So S, Marsh JW, Murphy AM. QT prolongation and Torsades de Pointes after administration of FK506. Transplantation. 1992;53(4):929-30.−⁴4. Nishimura M, Kim K, Uchiyama A, et al. Tacrolimus-induced life-threatening arrhythmia in a pediatric liver-transplant patient. Intensive Care Med. 2002;28(11):1683-4. 1 review of the literature⁵5. Marcassi AP, Yasbek DC, Pestana JO, et al. Ventricular arrhythmia in incident kidney transplant recipients: prevalence and associated factors. Transpl Int. 2011;24(1):67-72.
Cochrane Library	“Tacrolimus” AND “arrhythmia”	4 case reports¹1. Johnson MC, So S, Marsh JW, Murphy AM. QT prolongation and Torsades de Pointes after administration of FK506. Transplantation. 1992;53(4):929-30.−⁴4. Nishimura M, Kim K, Uchiyama A, et al. Tacrolimus-induced life-threatening arrhythmia in a pediatric liver-transplant patient. Intensive Care Med. 2002;28(11):1683-4. 1 review of the literature⁵5. Marcassi AP, Yasbek DC, Pestana JO, et al. Ventricular arrhythmia in incident kidney transplant recipients: prevalence and associated factors. Transpl Int. 2011;24(1):67-72.

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[1] Address for correspondence: Ho-Sik Shin, Department of Internal Medicine, Kosin University College of Medicine, 262 Gamcheon-ro, Seo-gu, Busan 602-702, Korea, Tel. +82-51-990-6108, Fax. +82-51-248-5686, E-mail: danieljoseph@hanmail.net