Short‐term response to phenytoin sodium in Andersen‐Tawil syndrome‐1 with a cardiac‐dominant phenotype.

Background: Andersen‐Tawil syndrome (ATS) is a rare familial periodic paralysis that typically also affects the heart and skeletal system. Ventricular arrhythmias (VAs) are profound and difficult to control, but minimally symptomatic. In this report, we describe an atypical phenotype of ATS in two r...

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Publicado en:Pacing & Clinical Electrophysiology Vol. 42; no. 2; pp. 201 - 208
Autores principales: Rai, Maneesh K., Pai, Rohith, Prabhu, Mukund A., Pasha, Syed Waleem, Kedambadi, Rakshith C., Kamath, Padmanabh, Augustine, Alfred J., Bhavani, Gangham SriLakshmi, Girisha, Katta M.
Formato: algorithm pictorial research tables/charts tracings Journal Article
Publicado: Wiley-Blackwell Feb2019
Acceso en línea:Ver este registro en EBSCOhost
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        atl: Short‐term response to phenytoin sodium in Andersen‐Tawil syndrome‐1 with a cardiac‐dominant phenotype.
      aug:
        au:
          Rai, Maneesh K.
          Pai, Rohith
          Prabhu, Mukund A.
          Pasha, Syed Waleem
          Kedambadi, Rakshith C.
          Kamath, Padmanabh
          Augustine, Alfred J.
          Bhavani, Gangham SriLakshmi
          Girisha, Katta M.
        affil: Department of Cardiology, Kasturba Medical College, Manipal Academy of Higher Education, Mangalore Karnataka, India
      sug:
        subj:
          Andersen-Tawil Syndrome Drug Therapy
          Phenotype
          Phenytoin Therapeutic Use
          Andersen-Tawil Syndrome Familial and Genetic
          Arrhythmia, Ventricular
          Human
          Treatment Outcomes
          Siblings
          Andersen-Tawil Syndrome Diagnosis
          Arrhythmia
          Genetic Screening
          Mutation
          Phenytoin Administration and Dosage
          Electrocardiography, Ambulatory
          Drug Tolerance
      ab: Background: Andersen‐Tawil syndrome (ATS) is a rare familial periodic paralysis that typically also affects the heart and skeletal system. Ventricular arrhythmias (VAs) are profound and difficult to control, but minimally symptomatic. In this report, we describe an atypical phenotype of ATS in two related families. We also report our experience with phenytoin sodium for the control of resistant VAs in these patients. Methods and Results: Between 2014 and 2018, seven siblings were diagnosed with ATS on the basis of cardiac arrhythmias and genetic evaluation. Heterozygous mutation with c.431G > C (p.G144A) in exon 2 of KCNJ2 gene was observed in all patients. Characteristic cardiac manifestations were noted in all patients but periodic paralysis or objective neurological involvement was distinctly absent. Phenytoin was considered for control of symptomatic VA in three patients. Intake of oral phenytoin (5 mg/kg/day) for 1 month completely suppressed VA (<1% in 24‐h Holter monitoring) in two patients, and significantly in the third (8% per 24 h) patient. Phenytoin was well‐tolerated in all three patients. Conclusions: We describe a cardiac‐predominant phenotype in ATS. ATS should be suspected in patients with typical cardiac manifestations even in the absence of periodic paralysis. Our initial experience with short‐term use of phenytoin for control of resistant VAs is encouraging.
      pubtype: Academic Journal
      doctype:
        algorithm
        pictorial
        research
        tables/charts
        tracings
        Journal Article
      ougenre: Article
    language: English
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