Successful limb salvage with prostaglandin infusion: a review of ergotamine toxicity.
OBJECTIVE
A case of severe acute peripheral arterial insufficiency secondary to ergotamine toxicity treated successfully with intravenously administered prostaglandin is presented to highlight the features of this condition and to demonstrate the efficacy of treatment with prostaglandin infusion.


METHODS
A 35-year-old unemployed Caucasian woman with a background of polypharmacy abuse and recurrent migraines presented to St Vincent's Hospital Emergency Department with limb-threatening ischaemia of both legs secondary to chronic ergotamine overuse.


RESULTS
A prostaglandin infusion was started and a dramatic and rapid improvement of her peripheral circulation occurred within six hours.


CONCLUSIONS
Ergotamine toxicity is an uncommon but well documented cause of peripheral vascular insufficiency that should be recognised and treated aggressively because its sequelae can be disastrous. Intravenously administered prostaglandin proved to be successful in this case and is a logical choice as first-line therapy for ergotamine toxicity.
Edwards
R J
RJ
Accident and Emergency Centre, St Vincent's Hospital, Darlinghurst, NSW.
Fulde
G W
GW
McGrath
M A
MA
D000328:Adult; D000527:Alprostadil / Q000008:administration & dosage*; D004334:Drug Administration Schedule; D004881:Ergotism / Q000150:complications / Q000188:drug therapy*; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D007866:Leg / Q000098:blood supply*; D008881:Migraine Disorders / Q000188:drug therapy; D016491:Peripheral Vascular Diseases / Q000188:drug therapy* / Q000209:etiology
D000527:Alprostadil