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Hypocalcaemic cardiac failure post BMT secondary to unrecognized vitamin D deficiency

Bone Marrow Transplantation volume 42, pages 363–364 (2008)Cite this article

Cardiac failure is not uncommon after BMT. It is usually multifactorial, contributed by chronic drug toxicity (anthracycline, BU, carmustine or cytarabine1, 2), previous irradiation or pre-existing heart diseases.1 Patients are particularly at risk in the immediate post transplant period because of the challenge from large volumes of intravenous fluid, and the additional risk of high-output cardiac failure precipitated by anaemia and infection. Given their known vulnerability to cardiac dysfunction, any potential precipitants should be minimized. Although electrolyte disturbances may occur post transplantation, hypocalcaemia resulting in cardiac failure has not been reported in BMT recipients. We report a case of decompensated cardiac failure post autologous stem cell BMT secondary to severe hypocalcaemia from unrecognized vitamin D deficiency, to highlight the importance of calcium homeostasis surveillance in BMT recipients.

Incidence of major cardiac events varies from 0.5 to 9% in several series.3, 4, 5 Cardiac tamponade and cardiac arrhythmias are the most common life-threatening events. Although hypocalcaemia may cause arrhythmia, the incidence of cardiac dysfunction secondary to hypocalcaemia in BMT recipients is unknown. Because of the specific milieu of transplantation, BMT recipients are at significant risk of unrecognized hypocalcaemia, which may further compromise cardiac function in at-risk individuals.

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Authors and Affiliations

  1. Department of Endocrinology, St Vincent's Hospital, Sydney, New South Wales, Australia

    P Lee & J R Center

  2. Garvan Institute of Medical Research, Sydney, New South Wales, Australia

    P Lee & J R Center

  3. Department of Hematology, St Vincent's Hospital, Sydney, New South Wales, Australia

    S Milliken

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  1. P Lee
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  2. S Milliken
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  3. J R Center
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Correspondence to P Lee.

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Lee, P., Milliken, S. & Center, J. Hypocalcaemic cardiac failure post BMT secondary to unrecognized vitamin D deficiency. Bone Marrow Transplant 42, 363–364 (2008). https://doi.org/10.1038/bmt.2008.178

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