Background
Case presentation
D0 (ED) | D1 | D2 | D3 | D4 | ||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
CPK (IU/L) | 8930 | 6220 | 2630 | 1929 | 1547 | 1200 | 640 | 536 | 260 | 240 | 107 | 53 |
TnT (ng/mL) | 1.06 | 0.339 | ||||||||||
ECG | Complete AV block | |||||||||||
TTE | LVEF > 70% | LVEF > 70% | ||||||||||
BP (mmHg) | 165/41 | 155/40 | 169/61 | 162/68 | 150/86 | 142/76 | 130/54 | 154/79 | 164/69 | 153/67 | ||
HR (beats/min) | 40 | 41 | 74 | 96 | 88 | 95 | 68 | 79 | 63 | 83 | ||
K (mmol/L) | 6.5 | 5.2 | 4.5 | 3.8 | 3.9 | 4.2 | 3.8 | 3.9 | 4.4 | 4.3 | 4.6 |
Discussion
Incidence of myocarditis and fatality outcomes
Question | Yes | Do not know | Score | |
---|---|---|---|---|
1. Are there previous conclusive reports on this reaction? | + 1 | 0 | 0 | + 1 |
2. Did the adverse event appear after the suspected drug was administered? | + 2 | − 1 | 0 | + 2 |
3. Did the adverse event improve when the drug was discontinued or a specific antagonist was administered? | + 1 | 0 | 0 | + 1 |
4. Did the adverse event reappear when the drug was readministered? | + 2 | − 1 | 0 | 0 |
5. Are there alternative causes that could on their own have caused the reaction? | − 1 | + 2 | 0 | + 2 |
6. Did the reaction reappear when a placebo was given? | − 1 | + 1 | 0 | 0 |
7. Was the drug detected in blood or other fluids in concentrations known to be toxic? | + 1 | 0 | 0 | 0 |
8. Was the reaction more severe when the dose was increased or less severe when the dose was decreased? | + 1 | 0 | 0 | 0 |
9. Did the patient have a similar reaction to the same or similar drugs in any previous exposure? | + 1 | 0 | 0 | 0 |
10. Was the adverse event confirmed by any objective evidence? | + 1 | 0 | 0 | 0 |
Total score: 6 |