{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,30]],"date-time":"2025-10-30T22:47:05Z","timestamp":1761864425632,"version":"3.44.0"},"reference-count":15,"publisher":"BMJ","issue":"4","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2022,4,7]]},"published-print":{"date-parts":[[2022,4]]},"abstract":"<jats:p>Congenital chloride losing diarrhoea (CCLD) is a rare disease caused by mutations in an intestinal chloride\/bicarbonate ion exchange channel. Few reports describe CCLD in adults and none has described the impact of a parasitic infection on CCLD. Severe diarrhoea may result in hypokalaemia with QT interval prolongation. Treatment with antiemetics may further increase the QT interval. To raise awareness of this preventable complication, we describe the course of a woman in her 20s with CCLD who developed COVID-19 and a <jats:italic>Blastocystis hominis<\/jats:italic> infestation. Treatment with antiemetics and hypokalaemia resulted in prolongation of the QT interval to 640 ms. While, the QT interval normalised with discontinuation of antiemetics and electrolyte replacement, patients with CCLD must take precautions to prevent gastrointestinal infections. Regardless, whenever patients with CCLD present to hospital, the authors recommend monitoring the QT interval and avoiding medications that predispose to torsade de pointes.<\/jats:p>","DOI":"10.1136\/bcr-2021-246175","type":"journal-article","created":{"date-parts":[[2022,5,23]],"date-time":"2022-05-23T11:53:40Z","timestamp":1653306820000},"page":"e246175","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Acquired long QT syndrome due to antiemetics, COVID-19 and <i>Blastocystis hominis<\/i> induced exacerbation of congenital chloride losing diarrhoea"],"prefix":"10.1136","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7790-4591","authenticated-orcid":false,"given":"Rajkumar","family":"Rajendram","sequence":"first","affiliation":[{"name":"College of Medicine, King Saud bin Abdulaziz University for Health Sciences College of Medicine, Riyadh, Al Riyadh Province, Saudi Arabia"},{"name":"Department of Medicine, King Abdulaziz Medical City, Riyadh, Al Riyadh Province, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ahmed Abdullah","family":"Alghamdi","sequence":"additional","affiliation":[{"name":"Department of Medicine, King Abdulaziz Medical City, Riyadh, Al Riyadh Province, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohammed Ayed","family":"Alanazi","sequence":"additional","affiliation":[{"name":"Department of Medicine, King Abdulaziz Medical City, Riyadh, Al Riyadh Province, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2022,4,26]]},"reference":[{"key":"2025082722181301000_15.4.e246175.1","doi-asserted-by":"crossref","first-page":"321","DOI":"10.4318\/tjg.2011.0219","article-title":"Congenital chloride diarrhea misdiagnosed as Bartter syndrome","volume":"22","author":"E\u011fr\u0131ta\u015f","year":"2011","journal-title":"Turk J Gastroenterol"},{"key":"2025082722181301000_15.4.e246175.2","first-page":"811","article-title":"Congenital chloride diarrhea","volume":"30","author":"Parikh","year":"1993","journal-title":"Indian Pediatr"},{"key":"2025082722181301000_15.4.e246175.3","doi-asserted-by":"crossref","first-page":"168","DOI":"10.1186\/s40249-020-00779-z","article-title":"Epidemiology of Blastocystis infection from 1990 to 2019 in China","volume":"9","author":"Ning","year":"2020","journal-title":"Infect Dis Poverty"},{"key":"2025082722181301000_15.4.e246175.4","doi-asserted-by":"crossref","first-page":"376","DOI":"10.1186\/s13071-019-3641-2","article-title":"A summary of Blastocystis subtypes in North and South America","volume":"12","author":"Jim\u00e9nez","year":"2019","journal-title":"Parasit Vectors"},{"key":"2025082722181301000_15.4.e246175.5","doi-asserted-by":"publisher","DOI":"10.1128\/CMR.00022-08"},{"key":"2025082722181301000_15.4.e246175.6","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.02520-15"},{"key":"2025082722181301000_15.4.e246175.7","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cir810"},{"key":"2025082722181301000_15.4.e246175.8","doi-asserted-by":"crossref","first-page":"64","DOI":"10.1186\/s40249-016-0157-2","article-title":"Impact of co-infections with enteric pathogens on children suffering from acute diarrhea in Southwest China","volume":"5","author":"Zhang","year":"2016","journal-title":"Infect Dis Poverty"},{"key":"2025082722181301000_15.4.e246175.9","first-page":"339","article-title":"Congenital chloride losing diarrhoea","volume":"64","author":"Gujrati","year":"2014","journal-title":"J Pak Med Assoc"},{"key":"2025082722181301000_15.4.e246175.10","doi-asserted-by":"crossref","first-page":"1928","DOI":"10.1016\/j.ajem.2017.08.044","article-title":"Emergency department approach to QTc prolongation","volume":"35","author":"Pourmand","year":"2017","journal-title":"Am J Emerg Med"},{"key":"2025082722181301000_15.4.e246175.11","unstructured":"Fass O . Antiemetics and QT prolongation. Clinical Correlations, 2021. 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