少見案例：阿比特龍導致突發性嚴重高血壓及低血鉀在閹割性前列腺癌病人
劉家睿醫師1, 楊明昕醫師1
1國防醫學院三軍總醫院外科部泌尿外科
A rare case of sudden onset of severe hypertension with hypokalemia due to using abiraterone acetate for a while in patient with castration-resistant prostate cancer
Chia-Ruei Liu, MD1, Yang-Ming Yang, MD1
1Division of Urology, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
Abstract
Introduction:
Abiraterone acetate is mostly used in castration-resistant metastatic prostate cancer (mCRPC). Hypotension or hypokalemia was side effects when using. We had experienced the case who had grade IV hypertension and hypokalemia suddenly when using abiraterone 3 months later.
Patient concerns: The patient had used abiraterone for 3 months, less side effects was noted. However, suddenly dizziness and vomiting was shown for 3 days, so he was admission and severe hypertension (190/110 mmHg) with hypokalemia (2.5 mmol/L) was noted. After series of examinations, high ACTH level also noted (210 pg/ml). Mineralocorticoid excess syndrome was noted.
Interventions:. Discontinued abiraterone and add exogenous glucocorticoid.
Outcomes: Dizziness and vomiting were got improved, hypertension and hypokalemia was subsided.
Disscussion: Grade IV hypertension and hypokalemia was noted at some patients by using abiraterone acetate. But this case used the drug for 3 months with less side effect, but severe effect was showed at this time. At clinical, we need to watch out this situation.