title: [Ergotism: an occasional unrecognized cause of acute ischemia of the extremities].
abstract: Vasospasm related to ergot intoxication has been recognised since the Middle Ages when it occurred due to ingestion of rye contaminated with Claviceps purpurea. Today ergotism is a rare cause of peripheral ischaemia, most often associated with ergotamine tartrate therapy for migraine headaches. Recognition of the typical angiographic pattern is important, as the classic drug history may not be obtained, and the cause of the ischaemia can be overlooked. Early diagnosis is important as the outcome may be serious if left untreated. Arterial vasospasm, collateralisation, and secondary thrombus formation are the major angiographic findings. Ergotism responds to conservative therapy which includes drug withdrawal, intravenous nitroprusside, fluid therapy and heparinisation. We describe the angiographic findings of four cases and report on the results of therapy.
authors.affiliation: Institut und Poliklinik für Radiologische Diagnostik der Universität zu Köln.
authors.forename: R
authors.initials: R
authors.lastname: Fischbach
authors.forename: W
authors.initials: W
authors.lastname: Gross-Fengels
authors.forename: R
authors.initials: R
authors.lastname: Schmidt
mesh_terms: D000328:Adult; D001939:Bread / Q000506:poisoning; D004878:Ergotamine; D004879:Ergotamines / Q000009:adverse effects / Q000627:therapeutic use; D004881:Ergotism / Q000150:complications*; D005121:Extremities / Q000098:blood supply*; D005260:Female; D006261:Headache / Q000188:drug therapy; D006801:Humans; D007511:Ischemia / Q000000981:diagnostic imaging / Q000209:etiology*; D011859:Radiography; D012434:Secale / Q000506:poisoning
chemical_list: D004879:Ergotamines; D004878:Ergotamine
vernacular_title: Der Ergotismus: Eine gelegentlich verkannte Ursache der akuten Extremitätenischämie.