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Acute limb ischemia due to ergotism
1Department of Surgery, Section of Vascular Surgery, Aga Khan University, Karachi, Pakistan.
Summary
Ergot poisoning can cause severe extremity ischemia, potentially leading to limb loss. Prompt diagnosis and treatment, including medication withdrawal or interventional procedures, are crucial for managing this condition.
Area of Science:
- Vascular Surgery
- Toxicology
- Emergency Medicine
Background:
- Acute extremity ischemia is a serious condition that can result in limb loss or death.
- Ergot alkaloids, found in certain medications, can cause vasoconstriction and ischemia.
Observation:
- Two cases of extremity ischemia due to ergot poisoning are presented.
- Case 1: A 60-year-old woman with left arm ischemia and gangrene, and right hand pain, secondary to ergot poisoning.
- Case 2: A patient with bilateral lower extremity ischemia, responsive to ergot-containing medicine withdrawal and nifedipine.
Findings:
- Severe arterial spasm was identified in Case 1 via catheterization and resolved with balloon angioplasty.
- Left hand amputation was necessary due to gangrene in Case 1.
- Lower extremity ischemia in Case 2 improved after discontinuing the ergot-containing medication.
Implications:
- This report highlights ergot poisoning as a potential cause of acute extremity ischemia.
- Early recognition and management are vital to prevent severe outcomes like limb loss.
- Treatment strategies may include medication adjustment, interventional radiology, and pharmacotherapy.