A Case of Abiraterone-Related Hypokalemia Leading to Torsades de Pointes and Cardiac Arrest

Dae Hyun Lee; David B Money; Akshay Deshpande; Brian Samuels

doi:10.7759/cureus.23678

A Case of Abiraterone-Related Hypokalemia Leading to Torsades de Pointes and Cardiac Arrest

Cureus. 2022 Mar 31;14(3):e23678. doi: 10.7759/cureus.23678. eCollection 2022 Mar.

Authors

Dae Hyun Lee¹, David B Money², Akshay Deshpande², Brian Samuels³

Affiliations

¹ Cardiology, University of South Florida, Tampa, USA.
² Internal Medicine, University of South Florida, Tampa, USA.
³ Emergency Medicine, University of South Florida, Tampa, USA.

Abstract

Abiraterone acetate is an androgen-depriving therapy (ADT) that is highly effective for treating castration-resistant prostate cancer (CRPC). By inhibiting CYP17, abiraterone can induce a state of mineralocorticoid excess, which is associated with profound hypokalemia. We present a case of abiraterone-related hypokalemia which led to torsades de pointes (TdP) and ventricular fibrillation (VF). We reviewed the literature and showed the need for close monitoring of the potassium level and electrocardiogram (ECG) to prevent fatal arrhythmias.

Keywords: abiraterone; cardio-oncology; cardiotoxicity; hypokalemia; torsades de pointes.

Publication types

Case Reports