Dermatology, Venereology and Leprology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India.
Dermatology, Venereology and Leprology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
BMJ Case Rep. 2024 Sep 12;17(9):e256303. doi: 10.1136/bcr-2023-256303.
Two men in their 60s and 40s were diagnosed with erythema nodosum leprosum based on the development of recurrent painful ulcers and nodules, respectively, for the previous 6 months. Thalidomide 100 mg four times a day, along with MB-MDT, was started in both patients. Both patients experienced severe dizziness on rising from a seated posture soon after initiation of thalidomide and a decrease in blood pressure and heart rate. Cardiovascular/neurology examination and routine blood investigations were normal. An autonomic nervous system assessment indicated bradycardia, postural hypotension and decreased cardiac autonomic function. The dosage of thalidomide was then gradually reduced over 4-5 days to 100 mg/day following a suspicion that thalidomide was the cause of postural hypotension. The dizziness subsided, and blood pressure and heart rate returned to normal.We concluded that thalidomide was the culprit behind bradycardia and dose- dependent postural hypotension.
两名六十多岁和四十多岁的男性，分别因反复出现疼痛性溃疡和结节，在过去 6 个月中被诊断为结节性红斑麻风病。两名患者均接受了沙利度胺 100mg，每日 4 次，联合 MB-MDT 治疗。在开始使用沙利度胺后不久，两名患者均出现严重的直立性头晕，血压和心率下降。心血管/神经病学检查和常规血液检查均正常。自主神经系统评估显示心动过缓、体位性低血压和心脏自主功能下降。随后怀疑沙利度胺是导致体位性低血压的原因，逐渐将沙利度胺的剂量减少 4-5 天至 100mg/天。头晕缓解，血压和心率恢复正常。我们得出结论，沙利度胺是导致心动过缓和剂量依赖性体位性低血压的罪魁祸首。
