Ergotamine
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Acute arterial occlusion: case report A 47-year-old woman presented with sudden-onset paraesthesia in both upper and lower limbs that had evolved over the previous 4 days. She had no history of heart disease, intermittent claudication or smoking, but reported chronic use of ergotamine for migraines [dosage and duration of treatment not stated]. Physical examination was remarkable for severe pain in her lower limbs, accompanied by absence of distal pulses and cyanosis of her toes. Lower limb arteriography revealed bilateral and symmetrical spasm of several arteries. Ergotamine was withdrawn, as well as heparin, cilostazol and buflomedil. Over the next 6 days, her pain and paraesthesia reduced, and distal pulses and normal colouration returned in her lower limbs; she was subsequently discharged. Author comment: "When arterial spasm is observed, especially if it is bilateral and symmetrical, intoxication by ergotamine should be suspected." De Souza EB, et al. Acute arterial occlusion caused by ergotamine derivatives. Jornal Vascular Brasileiro 8: No. 3, Sep 2009. Available from: URL: http:// 803014854 dx.doi.org/10.1590/s1677-54492009000300018 - Brazil
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Reactions 22 May 2010 No. 1302
