Unusual case of severe arrhythmia developed after acute intoxication with tosylchloramide 英文参考文献.docVIP
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Unusual case of severe arrhythmia developed after acute intoxication with tosylchloramide 英文参考文献
Laricciaetal.BMCPharmacologyandToxicology2013,14:8
/2050-6511/14/8
CASE REPORT
OpenAccess
Unusualcaseofseverearrhythmiadeveloped
afteracuteintoxicationwithtosylchloramide
VincenzoLariccia1?,AlessandraMoraca2?,MarcoMarini2,AnnamariaAssuntaNasti1,IlariaBattistoni2,
SalvatoreAmoroso1*andGianPieroPerna2
Abstract
Background:DrugsnotcommonlyconsideredtobecardioactiveagentsmaycauseprolongationoftheQT
intervalwithresultanttorsadesdepointesandventricularfibrillation.Thisformofdrugtoxicityoftencausescardiac
arrestorsuddendeath.
Casepresentation:Afteraccidentalingestionoftosylchloramideacaucasian77-year-oldwoman,withafamily
historyofcardiovasculardiseaseandhypertension,wasadmittedtotheintensivecareunitfollowingepisodesof
torsadesdepointeswithaprolongedQT/QTcinterval(640/542ms).Thepatientreceivedanimplantable
cardioverter-defibrillator,wasdischargedfromthehospitalwithnormalQT/QTcintervalanddidnotexperience
additionalventriculararrhythmiasduringoneyearoffollow-up.
Conclusion:Thisisthefirstreportconcerninganunusualcaseoftorsadesdepointesafteraccidentalintoxication
byingestionoftosylchloramide.Thepronouncedimpactoftheoxidyzingagenttosylchloramideontheactivityof
someoftheionchannelsregulatingtheQTintervalwasidentifiedasaprobablecauseofthearrhythmia.
Keywords:Tosylchloramide,Acuteintoxication,Arrhythmia,Ventricularfibrillation,Ionchannels
Background
syndrome. She had a history of hypertension; treated
Because of its high activity against fungi and bacteria, since 5 years with Perindopril (5 mg once daily) and a
tosylchloramide is a widely used disinfectant agent for family history of cardiovascular disease. Few hours after
common applications such household cleaning and the admission at the Emergency Room (ER) the patient
swimming pool disinfection.Many case reports describ- experienced a cardiac arrest due to a “Torsade de
ing tosylchloramide intoxication havebeen already pub- Pointes” (TdP) degenerated into ventricular fibrillation
lished in the past showing that the chronic
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