A case of tacrolimus-induced supraventricular arrhythmia after kidney transplantation

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 copy

A case of tacrolimus-induced supraventricular arrhythmia after kidney transplantation

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

Authorship SCIMAGO INSTITUTIONS RANKINGS

CONTEXT

Tacrolimus is a potent immunosuppressive drug often administered to transplant recipient patients and exhibits a variety of adverse cardiovascular effects.

CASE REPORT

We report a case of a 53-year-old Asian female who developed various arrhythmic phenomena including atrial premature complexes and supraventricular tachycardia after administration of tacrolimus.

CONCLUSION

Tacrolimus-associated arrhythmia after kidney transplantation may be life-threatening, and so patients undergoing this procedure should be carefully monitored.

Tacrolimus; Arrhythmias, cardiac; Kidney transplantation; Tachycardia, supraventricular; Atrial premature complexes

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