Department of Radiology, Başkent University Adana Medical and Research Center, Adana, Turkey.
Diagn Interv Radiol. 2010 Jun;16(2):165-7. doi: 10.4261/1305-3825.DIR.1931-08.2. Epub 2009 Oct 9.
Ergotamine-induced limb ischemia is rare and usually results from an accidental overdose. Several agents, including erythromycin and tetracycline, raise serum ergotamine levels and augment its effect. We present a case of acute lower limb ischemia with characteristic angiography findings of diffuse arterial spasm resulting from use of ergotamine and an erythromycin derivative, clarithromycin. The history of the patient and classic features seen on angiography helped us establish the diagnosis. The patient was successfully treated with low molecular heparin and epidural infusion of bupivacain. Since ergot vasospasm is a self limited and medically treatable condition, interventional radiologists must be aware of ergotamine-induced acute limb ischemia to avoid any unnecessary interventional procedures, unless necrosis and gangrene are imminent.
麦角胺引起的肢体缺血罕见，通常是由于意外过量引起的。一些药物，包括红霉素和四环素，会提高血清麦角胺水平并增强其作用。我们报告了一例因使用麦角胺和红霉素衍生物克拉霉素引起的急性下肢缺血病例，其特征性的血管造影表现为弥漫性动脉痉挛。患者的病史和血管造影上的典型特征帮助我们确立了诊断。该患者成功地接受了低分子肝素和布比卡因硬膜外输注治疗。由于麦角血管痉挛是一种自限性和可治疗的疾病，介入放射科医生必须意识到麦角胺引起的急性肢体缺血，以避免任何不必要的介入治疗，除非坏死和坏疽即将发生。
