Panitumumab-Induced Severe Hypomagnesemia and Risk of Atrial Fibrillation and QT Prolongation: An Electrophysiologic Perspective
| Author | Azin Alizadehasl | en |
| Author | Haniyeh Faraji Azad | en |
| Author | Sara Adimi | en |
| Author | Amirhossein Shirinezhad | en |
| Orcid | Azin Alizadehasl [0000-0002-8550-1378] | en |
| Orcid | Sara Adimi [0000-0002-1060-6036] | en |
| Orcid | Amirhossein Shirinezhad [0009-0003-7718-1938] | en |
| Accessioned Date | 2026-08-08T20:22:21Z | |
| Issued Date | 2026-12-31 | en |
| Abstract | Introduction: Panitumumab-induced hypomagnesemia disrupts calcium and potassium channel function, prolongs the corrected QT (QTc) interval, and may create a substrate for atrial arrhythmogenesis. We describe a patient with metastatic colon cancer who developed severe hypomagnesemia and marked QTc prolongation during panitumumab therapy; however, atrial fibrillation did not occur. This case demonstrates rapid electrophysiological recovery after magnesium repletion and underscores the importance of cardiac monitoring in patients receiving epidermal growth factor receptor inhibitors. Case Presentation: A 68-year-old man with metastatic colon cancer receiving folinic acid, fluorouracil, and irinotecan plus panitumumab developed progressive hypomagnesemia, with the serum magnesium level decreasing from 0.78 mmol/L at baseline to 0.33 mmol/L by cycle 8, accompanied by hypokalemia. He remained asymptomatic. Before cycle 9, electrocardiography showed normal sinus rhythm without atrial fibrillation; however, the QTc interval had increased by 50 ms from baseline, from 410 to 460 ms. Panitumumab was withheld, and magnesium and potassium were repleted. Follow-up electrocardiography showed normalization of the QTc interval to 415 ms without atrial or ventricular arrhythmia. Conclusions: Panitumumab can cause clinically silent yet progressive hypomagnesemia, which may disrupt cardiac conduction and increase the risk of arrhythmias. Timely electrolyte repletion may reverse QTc prolongation, prevent arrhythmias, and allow continuation of anticancer therapy. Vigilant monitoring and prompt intervention are essential. | en |
| DOI | https://doi.org/10.69107/mca-172632 | en |
| URI | https://brieflands.com/journals/mca/articles/172632 | en |
| URI | https://repository.brieflands.com/handle/123456789/68098 | |
| Keyword | Panitumumab | en |
| Keyword | Hypomagnesemia | en |
| Keyword | Atrial Fibrillation | en |
| Keyword | Prolonged QTc | en |
| Keyword | Electrophysiology | en |
| Publisher | Brieflands | en |
| Title | Panitumumab-Induced Severe Hypomagnesemia and Risk of Atrial Fibrillation and QT Prolongation: An Electrophysiologic Perspective | en |
| Type | Case Report | en |
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