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Complete heart block in a neutropenic patient with aspergillosis: An unusual adverse effect of caspofungins

We present a case of complete heart block (CHB) in a 58-year-old female patient with acute myeloid leukemia (AML) with no past history of cardiac disease, who received caspofungin in the treatment of disseminated fungal infection. To our knowledge, this is the first case of CHB associated with caspo...

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Autor principal: Biswal, Sasmita
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medknow Publications & Media Pvt Ltd 2012
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3543560/
https://www.ncbi.nlm.nih.gov/pubmed/23326111
http://dx.doi.org/10.4103/0976-500X.103697
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author Biswal, Sasmita
author_facet Biswal, Sasmita
author_sort Biswal, Sasmita
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description We present a case of complete heart block (CHB) in a 58-year-old female patient with acute myeloid leukemia (AML) with no past history of cardiac disease, who received caspofungin in the treatment of disseminated fungal infection. To our knowledge, this is the first case of CHB associated with caspofungins. Subsequent to induction chemotherapy the patient developed invasive pulmonary aspergillosis with sudden tachypnea, dyspnoea, fever, bilateral pulmonary infiltrates and acute respiratory insufficiency consequent to neutropenia with ANC<500. During the first dose of antifungal therapy with caspofungins, she developed complete atrioventricular block and cardiac arrest. Complete heart block is an unusual adverse effect of caspofungins which has not been reported previously. Caspofungins release histamine in peripheral blood cells, so possible histamine-mediated symptoms ranging from severe fatal anaphylaxis can occur. These data suggest that infusion-related reactions associated with caspofungin may be mediated by histamine release secondary to caspofungin therapy.
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spelling pubmed-35435602013-01-16 Complete heart block in a neutropenic patient with aspergillosis: An unusual adverse effect of caspofungins Biswal, Sasmita J Pharmacol Pharmacother Case Report We present a case of complete heart block (CHB) in a 58-year-old female patient with acute myeloid leukemia (AML) with no past history of cardiac disease, who received caspofungin in the treatment of disseminated fungal infection. To our knowledge, this is the first case of CHB associated with caspofungins. Subsequent to induction chemotherapy the patient developed invasive pulmonary aspergillosis with sudden tachypnea, dyspnoea, fever, bilateral pulmonary infiltrates and acute respiratory insufficiency consequent to neutropenia with ANC<500. During the first dose of antifungal therapy with caspofungins, she developed complete atrioventricular block and cardiac arrest. Complete heart block is an unusual adverse effect of caspofungins which has not been reported previously. Caspofungins release histamine in peripheral blood cells, so possible histamine-mediated symptoms ranging from severe fatal anaphylaxis can occur. These data suggest that infusion-related reactions associated with caspofungin may be mediated by histamine release secondary to caspofungin therapy. Medknow Publications & Media Pvt Ltd 2012 /pmc/articles/PMC3543560/ /pubmed/23326111 http://dx.doi.org/10.4103/0976-500X.103697 Text en Copyright: © Journal of Pharmacology and Pharmacotherapeutics http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Report
Biswal, Sasmita
Complete heart block in a neutropenic patient with aspergillosis: An unusual adverse effect of caspofungins
title Complete heart block in a neutropenic patient with aspergillosis: An unusual adverse effect of caspofungins
title_full Complete heart block in a neutropenic patient with aspergillosis: An unusual adverse effect of caspofungins
title_fullStr Complete heart block in a neutropenic patient with aspergillosis: An unusual adverse effect of caspofungins
title_full_unstemmed Complete heart block in a neutropenic patient with aspergillosis: An unusual adverse effect of caspofungins
title_short Complete heart block in a neutropenic patient with aspergillosis: An unusual adverse effect of caspofungins
title_sort complete heart block in a neutropenic patient with aspergillosis: an unusual adverse effect of caspofungins
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3543560/
https://www.ncbi.nlm.nih.gov/pubmed/23326111
http://dx.doi.org/10.4103/0976-500X.103697
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