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Electrocardiographic changes during Treatment of Leishmaniasis with Pentavalent Antimony (Sodium Stibogluconate)^*

Jeffrey D. Chulay, Harrison C. Spencer AND Mutuma Mugambi

Serial electrocardiograms (ECGs) were obtained during 65 courses of sodium stibogluconate treatment in 59 Kenyan patients with leishmaniasis (56 visceral and 3 cutaneous). ECG abnormalities developed during 54% of the treatment courses. The frequency with which abnormalities occurred was related to the total daily dose of antimony (Sb), increasing from 2/9 patients treated with 10 mg Sb/kg/d to 25/48 treated with 20–30 mg Sb/kg/d and 8/8 treated with 40–60 mg Sb/kg/d. The frequency with which ECG abnormalities developed was also related to the duration of treatment, increasing from 11/65 patients after 7 days to 18/44 after 15 days, 26/39 after 30 days and 11/12 after 60 days. ECG abnormalities were similar to those previously described during treatment with trivalent antimonial drugs, the most common being flattening and/or inversion of T waves. Prolongation of the corrected QT interval occurred in 13 patients, all of whom were treated for more than 30 days or with more than 20 mg Sb/kg/d. One patient died suddenly during the fourth week of treatment with 60 mg Sb/kg/d, and 2 patients died of measles after 9 or 10 days of treatment with 30 mg Sb/kg/d. QT prolongation and a concave ST segment developed in all 3 patients who died. We conclude that minor ECG abnormalities are common when sodium stibogluconate is used at doses above 20 mg Sb/kg/d for more than 15 days, and that life-threatening arrhythmias may occur if very high doses are used.

Accepted for publication January 25, 1985.

^* The views of the authors do not purport to reflect the position of the Department of the Army or the Department of Defense (para 4-3, AR 360-5), or the U.S. Public Health Service, the Department of Health and Human Services, or the government of Kenya; nor does the use of trade names and commercial sources imply endorsement by any of these agencies.

Address reprints requests to: Department of Academic Affairs, Walter Reed Army Institute of Research, Washington, DC 20307-5100.

Present address: Department of Immunology, Walter Reed Army Institute of Research, Washington, DC 20307-5100.

This article has been cited by other articles:

				Y. A. Kuryshev, L. Wang, B. A. Wible, X. Wan, and E. Ficker Antimony-Based Antileishmanial Compounds Prolong the Cardiac Action Potential by an Increase in Cardiac Calcium Currents Mol. Pharmacol., April 1, 2006; 69(4): 1216 - 1225. [Abstract] [Full Text] [PDF]