Generic placeholder image

Current Drug Safety

Editor-in-Chief

ISSN (Print): 1574-8863
ISSN (Online): 2212-3911

Case Report

Ascending Flaccid Paralysis Secondary to Hypokalemia in A Cancer Patient using Abiraterone - A Case Report

Author(s): Daniella Cristina Brites de Almeida*, Aline Luiza Costa, Barbara Lacerda de Oliveira Faria, Frederico Bruzzi de Carvalho and Marco Tulio Gualberto Cintra

Volume 18, Issue 1, 2023

Published on: 27 April, 2022

Page: [107 - 111] Pages: 5

DOI: 10.2174/1574886317666220425140053

Price: $65

conference banner
Abstract

Background: Prostate cancer (PC) is the most common type of neoplasm in men and the fourth leading cause of mortality in Brazil. The prostate cancer refractory metastatic castration can be treated with abiraterone acetate (AA).

Case Presentation: Its use has been associated with increased survival. However, there are also side effects associated with the use of this drug, such as severe electrolyte disturbances.

Conclusion: The objective is to report the clinical case of a patient with castration-resistant metastatic prostate cancer who developed ascending flaccid paralysis secondary to severe hypokalemia, probably due to hyperaldosteronism secondary to the use of Abiraterone Acetate, despite the use of Prednisone.

Keywords: Abiraterone acetate, prostate neoplasms, hypokalemia, paralysis, case report, electrolyte disturbances.

Graphical Abstract
[1]
Weber F, Jurkat-Rott K, Lehmann-Horn F. Hyperkalemic Periodic Paralysis. In: Adam MP, Ardinger HH, Pagon RA, Eds. Gene Reviews. 1993-2020.
[2]
de Bono JS, Logothetis CJ, Molina A, et al. Abiraterone and increased survival in metastatic prostate cancer. N Engl J Med 2011; 364(21): 1995-2005.
[http://dx.doi.org/10.1056/NEJMoa1014618] [PMID: 21612468]
[3]
Fizazi K, Scher HI, Molina A, et al. Abiraterone acetate for treatment of metastatic castration-resistant prostate cancer: final overall survival analysis of the COU-AA-301 randomised, double-blind, placebo-controlled phase 3 study. Lancet Oncol 2012; 13(10): 983-92.
[http://dx.doi.org/10.1016/S1470-2045(12)70379-0] [PMID: 22995653]
[4]
Fizazi K, Tran N, Fein L, et al. Abiraterone plus prednisone in metastatic, castration-sensitive prostate cancer. N Engl J Med 2017; 377(4): 352-60.
[http://dx.doi.org/10.1056/NEJMoa1704174] [PMID: 28578607]
[5]
Rodríguez SG, Móstoles NM, de Paz PI, Eduardina C, Ranero T, Blanco PC. When to suspect periodic paralysis: report of clinical case? Rev Clin Med Fam 2015; 8(3): 261-4.
[6]
Rodieux F, Nieto N, Sunthorn H, John G, Escher M. Abiraterone acetate-induced life-threatening torsade de pointes. Ann Pharmacother 2015; 49(1): 152-3.
[http://dx.doi.org/10.1177/1060028014555362] [PMID: 25524931]
[7]
Garg RK, Malhotra HS, Verma R, Sharma P, Singh MK. Etiological spectrum of hypokalemic paralysis: A retrospective analysis of 29 patients. Ann Indian Acad Neurol 2013; 16(3): 365-70.
[http://dx.doi.org/10.4103/0972-2327.116934] [PMID: 24101818]
[8]
Rajvanshi JB, Chaudhary MD, Malekar PD, Singhal NK, Alurkar SS. Quadriplegia secondary to abiraterone-induced severe hypokalemia. South Asian J Cancer 2019; 8(3): 139-44.
[http://dx.doi.org/10.4103/sajc.sajc_343_18] [PMID: 31489282]
[9]
Gupta A, Khanna VN, Rizvi I, Gupta A. Secondary hypokalaemic paralysis. BMJ Case Rep 2012; 2012: bcr0320126135.
[http://dx.doi.org/10.1136/bcr-03-2012-6135] [PMID: 23035156]
[10]
McKay RR, Werner L, Jacobus SJ, et al. A phase 2 trial of abiraterone acetate without glucocorticoids for men with metastatic castration-resistant prostate cancer. Cancer 2019; 125(4): 524-32.
[http://dx.doi.org/10.1002/cncr.31836] [PMID: 30427533]
[11]
Matsubara N, Uemura H, Satoh T, et al. A phase 2 trial of abiraterone acetate in Japanese men with metastatic castration-resistant prostate cancer and without prior chemotherapy (JPN-201 study). Jpn J Clin Oncol 2014; 44(12): 1216-26.
[http://dx.doi.org/10.1093/jjco/hyu149] [PMID: 25320340]
[12]
Mulders PF, Molina A, Marberger M, et al. Efficacy and safety of abiraterone acetate in an elderly patient subgroup (aged 75 and older) with metastatic castration-resistant prostate cancer after docetaxel-based chemotherapy. Eur Urol 2014; 65(5): 875-83.
[http://dx.doi.org/10.1016/j.eururo.2013.09.005] [PMID: 24099659]
[13]
Statland JM, Fontaine B, Hanna MG, et al. Review of the diagnosis and treatment of periodic paralysis. Muscle Nerve 2018; 57(4): 522-30.
[http://dx.doi.org/10.1002/mus.26009] [PMID: 29125635]
[14]
Pia A, Vignani F, Attard G, et al. Strategies for managing ACTH dependent mineralocorticoid excess induced by abiraterone. Cancer Treat Rev 2013; 39(8): 966-73.
[http://dx.doi.org/10.1016/j.ctrv.2013.03.003] [PMID: 23582279]
[15]
Jamani R, Lee EK, Berry SR, et al. High prevalence of potential drug-drug interactions in patients with castration-resistant prostate cancer treated with abiraterone acetate. Eur J Clin Pharmacol 2016; 72(11): 1391-9.
[http://dx.doi.org/10.1007/s00228-016-2120-3] [PMID: 27561266]
[16]
Drugs.com. Abiteratone Drug Interaction. Available from: https:// www.drugs.com/drug-interactions/abiteratone-index.html [accessed Jul 20, 2020].
[17]
Ryan CJ, Smith MR, Fizazi K, et al. Abiraterone acetate plus prednisone versus placebo plus prednisone in chemotherapy-naive men with metastatic castration-resistant prostate cancer (COUAA-302): final overall survival analysis of a randomised, double-blind, placebo-controlled phase 3 study. Lancet Oncol 2015; 16(2): 152-60.
[http://dx.doi.org/10.1016/S1470-2045(14)71205-7] [PMID: 25601341]

Rights & Permissions Print Cite
© 2024 Bentham Science Publishers | Privacy Policy