Palpitations developed following treatment with colchicines

Abstract

Torsade de pointes is a form of polymorphic ventricular tachycardia occurring in a setting of prolonged QT interval as represented on surface electrocardiogram. A 40 year old man with the chief complaint of generalized weakness and increased heart rate (palpitation) was brought to hospital. The patient was known to have familial Mediterranean fever (FMF) and was receiving treatment (colchicines) for his condition. During acquiring the ECG, an episode of palpitation occurred and dysrythmia was observed in patient’s electrocardiogram. The blood level of Ca was normal but Mg level was lower than the normal range (0.3)in this patient, indicating a hypomagnesemia possibly caused by colchicines, which, in turn, might result in torsade de pointes.
Colchicines is the choice drug for the treatment of FMF. Colchicines can reduce disease activity and prevent amyeloidosis. Colchicines overdose carries a high mortality risk (because of resulting cardiac arrhythmias). Electrolyte abnormalities that may be observed in patients with colchicines toxicity include hypocalcemia, hypophosphatemia, hyponatremia and hypomagnesemia. Mg deficiency produces a variety of clinical manifestations, including cardiac arrhythmias, such assupraventricular tachycardia and torsade de pointes.
So in patients with FMF palpitation and torsade de pointes may occur due to Colchicines induced hypomagnesaemia. Therefore, patients who experience palpitations and who have a history of FMF may develop torsade de pointes resulting from colchicines induced hypomagnesemia.