Serious Hypokalemia Associated with Abiraterone Acetate in Patients with Castration-Resistant Prostate Cancer
Introduction. The treatment strategy for castration-resistant prostate cancer (CRPC) has changed with the approval of several new agents. In 2011, abiraterone acetate was approved for the treatment of metastatic CRPC; however abiraterone is known to cause mineralocorticoid excess syndrome characteri...
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Wiley
2018-01-01
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| Series: | Case Reports in Urology |
| Online Access: | http://dx.doi.org/10.1155/2018/1414395 |
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| author | Yutaka Yamamoto Yasunori Akashi Takahumi Minami Masahiro Nozawa Keisuke Kiba Motokiyo Yoshikawa Akihide Hirayama Hirotsugu Uemura |
| author_facet | Yutaka Yamamoto Yasunori Akashi Takahumi Minami Masahiro Nozawa Keisuke Kiba Motokiyo Yoshikawa Akihide Hirayama Hirotsugu Uemura |
| author_sort | Yutaka Yamamoto |
| collection | DOAJ |
| description | Introduction. The treatment strategy for castration-resistant prostate cancer (CRPC) has changed with the approval of several new agents. In 2011, abiraterone acetate was approved for the treatment of metastatic CRPC; however abiraterone is known to cause mineralocorticoid excess syndrome characterized by hypokalemia, fluid retention, and hypertension. We experienced two cases of grade 4 hypokalemia associated with abiraterone treatment. Case Presentation. Case 1: a 71-year-old male with metastatic CRPC presented with convulsive seizures two weeks after receiving abiraterone plus prednisone. The serum potassium level was 2.1mEq/l. We determined that convulsive seizure was caused by hypokalemia associated with abiraterone. Case 2: a 68-year-old male with metastatic CRPC presented with severe lethargy one month after receiving abiraterone plus prednisone. The serum potassium level was 1.7mEq/l and we concluded that severe lethargy was caused by hypokalemia associated with abiraterone. They were treated with potassium supplementation and increased prednisone following withdrawal of abiraterone. Discussion. The two patients had been on glucocorticoid therapy before abiraterone therapy. Prolonged administration of exogenous glucocorticoid can lead adrenocortical insufficiency and consequently reduce endogenous glucocorticoid production. This situation may increase the risk of abiraterone-induced mineralocorticoid excess. To reduce the risk of abiraterone-induced hypokalemia, evaluation of adrenocortical insufficiency is required. |
| format | Article |
| id | doaj-art-c7b00fa913474460bb0ce8f956ffa433 |
| institution | OA Journals |
| issn | 2090-696X 2090-6978 |
| language | English |
| publishDate | 2018-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Urology |
| spelling | doaj-art-c7b00fa913474460bb0ce8f956ffa4332025-08-20T02:20:05ZengWileyCase Reports in Urology2090-696X2090-69782018-01-01201810.1155/2018/14143951414395Serious Hypokalemia Associated with Abiraterone Acetate in Patients with Castration-Resistant Prostate CancerYutaka Yamamoto0Yasunori Akashi1Takahumi Minami2Masahiro Nozawa3Keisuke Kiba4Motokiyo Yoshikawa5Akihide Hirayama6Hirotsugu Uemura7Department of Urology, Nara Hospital, Kindai University Faculty of Medicine, 1248-1 Otodacho Ikoma, Nara 630-0293, JapanDepartment of Urology, Nara Hospital, Kindai University Faculty of Medicine, 1248-1 Otodacho Ikoma, Nara 630-0293, JapanDepartment of Urology, Kindai University Faculty of Medicine, 377-2 Ohno-Higashi, Osakasayama, Osaka 589-8511, JapanDepartment of Urology, Kindai University Faculty of Medicine, 377-2 Ohno-Higashi, Osakasayama, Osaka 589-8511, JapanDepartment of Urology, Nara Hospital, Kindai University Faculty of Medicine, 1248-1 Otodacho Ikoma, Nara 630-0293, JapanDepartment of Urology, Nara Hospital, Kindai University Faculty of Medicine, 1248-1 Otodacho Ikoma, Nara 630-0293, JapanDepartment of Urology, Nara Hospital, Kindai University Faculty of Medicine, 1248-1 Otodacho Ikoma, Nara 630-0293, JapanDepartment of Urology, Kindai University Faculty of Medicine, 377-2 Ohno-Higashi, Osakasayama, Osaka 589-8511, JapanIntroduction. The treatment strategy for castration-resistant prostate cancer (CRPC) has changed with the approval of several new agents. In 2011, abiraterone acetate was approved for the treatment of metastatic CRPC; however abiraterone is known to cause mineralocorticoid excess syndrome characterized by hypokalemia, fluid retention, and hypertension. We experienced two cases of grade 4 hypokalemia associated with abiraterone treatment. Case Presentation. Case 1: a 71-year-old male with metastatic CRPC presented with convulsive seizures two weeks after receiving abiraterone plus prednisone. The serum potassium level was 2.1mEq/l. We determined that convulsive seizure was caused by hypokalemia associated with abiraterone. Case 2: a 68-year-old male with metastatic CRPC presented with severe lethargy one month after receiving abiraterone plus prednisone. The serum potassium level was 1.7mEq/l and we concluded that severe lethargy was caused by hypokalemia associated with abiraterone. They were treated with potassium supplementation and increased prednisone following withdrawal of abiraterone. Discussion. The two patients had been on glucocorticoid therapy before abiraterone therapy. Prolonged administration of exogenous glucocorticoid can lead adrenocortical insufficiency and consequently reduce endogenous glucocorticoid production. This situation may increase the risk of abiraterone-induced mineralocorticoid excess. To reduce the risk of abiraterone-induced hypokalemia, evaluation of adrenocortical insufficiency is required.http://dx.doi.org/10.1155/2018/1414395 |
| spellingShingle | Yutaka Yamamoto Yasunori Akashi Takahumi Minami Masahiro Nozawa Keisuke Kiba Motokiyo Yoshikawa Akihide Hirayama Hirotsugu Uemura Serious Hypokalemia Associated with Abiraterone Acetate in Patients with Castration-Resistant Prostate Cancer Case Reports in Urology |
| title | Serious Hypokalemia Associated with Abiraterone Acetate in Patients with Castration-Resistant Prostate Cancer |
| title_full | Serious Hypokalemia Associated with Abiraterone Acetate in Patients with Castration-Resistant Prostate Cancer |
| title_fullStr | Serious Hypokalemia Associated with Abiraterone Acetate in Patients with Castration-Resistant Prostate Cancer |
| title_full_unstemmed | Serious Hypokalemia Associated with Abiraterone Acetate in Patients with Castration-Resistant Prostate Cancer |
| title_short | Serious Hypokalemia Associated with Abiraterone Acetate in Patients with Castration-Resistant Prostate Cancer |
| title_sort | serious hypokalemia associated with abiraterone acetate in patients with castration resistant prostate cancer |
| url | http://dx.doi.org/10.1155/2018/1414395 |
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