TORSADES DE POINTE WITH SPIRAMYCIN AND ME QUITAZINE THERAPY - A CASE-REPORT

The authors report the case of a 21 year old woman with a congenital l ong Q7 syndrome who had several syncopal attacks at least one of which was caused by torsades de pointe. This sudden complication was attrib uted to the simultaenous prescription of Spiramycine and Mequitazine o ver a 48 hour period. These two drugs are not considered to be predisp osing factors for torsades de pointe despite the fact that they belong to two families of drugs which can trigger this type of arrhythmia. T he withdrawal of this treatment led to the complete regression of the syncopal episodes with a follow-up of two years and a significant shor tening of the initial QTc interval which remained, nevertheless, longe r than normal. This case underlines the potential risks of drug associ ations of these two families of drugs, especially in patients with the congenital long Qt syndrome.