title: Lower extremity vasospasm associated with ischemic neuropathy, dermal fibrosis, and digital gangrene in a patient with carcinoid syndrome.
abstract: Bilateral lower extremity vasospasm associated with severe pain and hyperesthesias in the legs, and digital gangrene in both feet developed in a 50-year-old man with carcinoid syndrome. Nifedipine and chemical lumbar sympathectomy were partially effective in relieving the vasospasm. Electromyographic findings were consistent with ischemic neuropathy. A skin biopsy specimen showed striking dermal fibrosis. Serotonin and other vasoconstrictor substances released from the tumor may be responsible for the vasospasm, the dermal sclerosis, and the ischemic neuropathy. The early use of lumbar sympathectomy in patients with lower extremity vasospasm may prevent these irreversible ischemic complications.
authors.affiliation: Department of Medicine, University of Health Sciences, Chicago Medical School, IL 60064.
authors.forename: O
authors.initials: O
authors.lastname: Kucuk
authors.forename: G
authors.initials: G
authors.lastname: Noskin
authors.forename: K
authors.initials: K
authors.lastname: Petersen
authors.forename: E
authors.initials: E
authors.lastname: Ezdinli
authors.forename: D
authors.initials: D
authors.lastname: Rollins
authors.forename: S
authors.initials: S
authors.lastname: Singh
authors.forename: S
authors.initials: S
authors.lastname: Sarpel
mesh_terms: D001984:Bronchial Neoplasms / Q000503:physiopathology*; D002276:Carcinoid Tumor / Q000503:physiopathology*; D002318:Cardiovascular Diseases / Q000150:complications*; D005355:Fibrosis; D005734:Gangrene / Q000150:complications; D006801:Humans; D007866:Leg / Q000098:blood supply; D008113:Liver Neoplasms / Q000556:secondary; D008297:Male; D008875:Middle Aged; D012871:Skin Diseases / Q000150:complications*; D013577:Syndrome; D014662:Vasoconstrictor Agents / Q000097:blood
chemical_list: D014662:Vasoconstrictor Agents