Alcoholic liver cirrhosis complicated with torsade de pointes during plasma exchange and hemodiafiltration

A 36-year-old man with severe alcoholic hepatitis was treated with plasma e xchange combined with hemodiafiltration to remove endotoxins and inflammato ry cytokines. During the treatment, he had critical arrhythmia (torsade de pointes [TdP]). His laboratory data showed hypomagnesemia, which was suspec ted to be responsible for the development of TdP. Patients with alcoholic l iver disease tend to have hypomagnesemia and Q-T interval prolongation. Fur thermore, hemodiafiltration may cause hypomagnesemia. Careful observation f or electrolytic imbalance is necessary when clinicians treat patients with alcoholic liver failure with a liver support system.