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Erythromycin-associated ergotamine intoxication: Arteriographic and electrophysiologic analysis of a rare cause of severe ischemia of the lower extremities and associated ischemic neuropathy

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Annals of Vascular Surgery

Abstract

Vasospasm associated with ergotamine is a well-known phenomenon. In this case report we present a rare drug interaction between erythromycin and ergotamine at normal doses causing lower extremity ischemia in a 36-year-old woman. Nitroprusside proved to be the treatment of choice. The response was dramatic and took place in a matter of hours in this patient. Ischemic monomelic neuropathy is a recently described entity in which axonal necrosis is caused by a loss of distal extremity blood flow. The association between erythromycin and ergotamine may be a dangerous pharmacologic combination; drugs that have a hepatic cycle with ergotamine derivatives must be used with caution.

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Authors and Affiliations

  1. Department of Surgery, St. Sacrement Hospital, Laval University, 1050, Chemin Sainte-Foy, G1S 4L8, Quebec (Québec), Canada

    Rafik Ghali MD, Yvan Douville MD (FRCSC), Henri-Paul Noël MD (FRCSC) & Raymond Labbé MD (FRCSC)

  2. Department of Neurology, St. Sacrement Hospital, Laval University, Quebec, Canada

    Jacques De Léan MD (FRCPC)

Authors
  1. Rafik Ghali MD
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  2. Jacques De Léan MD
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  3. Yvan Douville MD
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  4. Henri-Paul Noël MD
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  5. Raymond Labbé MD
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Ghali, R., De Léan, J., Douville, Y. et al. Erythromycin-associated ergotamine intoxication: Arteriographic and electrophysiologic analysis of a rare cause of severe ischemia of the lower extremities and associated ischemic neuropathy. Annals of Vascular Surgery 7, 291–296 (1993). https://doi.org/10.1007/BF02000258

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