2015 Volume 6 Issue 1 Pages 71-73
【Case】An 82 year-old woman with bronchial asthma was transferred to our hospital following an asthma attack. Her serum electrolytes showed slight hypokalemia (3.4 mEq/L) on admission and her serum theophylline concentration (STC) was 33.7μg/mL. Torsade de Pointes (TdP) and ventricular fibrillation (VF) developed soon after she was hospitalized, and they did so again 11 hours later. Serum electrolytes revealed hypokalemia (3.0 mEq/L), with STC decreased to 19.8μg/mL, and Corrected QT Interval (QTc) in electrocardiogram at 483 msec. We then performed direct hemoperfusion (DHP) and continuous hemofiltration (CHF). After performing continuous DHP for 4 hours, STC decreased to 5.9μg/mL. We performed CHF alone for 2 days after finishing DHP, and STC decreased to 2.3μg/mL. The ventricular arrhythmia disappeared after we performed DHP, and hemodynamics stabilized at that time. 【Conclusion】 In this case, though the patient’s condition interacted with acute theophylline intoxication, hypokalemia, and QT prolongation to cause potentially lethal arrhythmia as a poisoning symptom, DHP and CRT proved to be effective treatment.
