title: Chronic ergot toxicity: A rare cause of lower extremity ischemia.
abstract: Chronic ergot toxicity is a rare cause of lower extremity ischemia. The cornerstone of therapy in ergot toxicity is to discontinue the use of caffeine, cigarettes, and all ergot-containing medications. Although multiple different therapies have been recommended for acute toxicity, no specific treatment is uniformly recommended in chronic toxicity. We present a case of long-term ergot use for migraine headaches in a woman who had severe chronic lower extremity claudication. This case demonstrates the unique features associated with the diagnosis and management of chronic ergot toxicity. We recommend a conservative approach consisting of observation, antiplatelet agents, and the discontinuance of ergots. If symptoms progress to rest pain or gangrene, surgical treatment should be considered.
authors.affiliation: Department of Surgery, Womack Army Medical Center, Ft Bragg, NC, USA.
authors.forename: G D
authors.initials: GD
authors.lastname: Garcia
authors.forename: J M
authors.initials: JM
authors.lastname: Goff
authors.forename: N C
authors.initials: NC
authors.lastname: Hadro
authors.forename: S D
authors.initials: SD
authors.lastname: O'donnell
authors.forename: P S
authors.initials: PS
authors.lastname: Greatorex
mesh_terms: D000328:Adult; D002110:Caffeine / Q000009:adverse effects; D002908:Chronic Disease; D003501:Cyclizine / Q000009:adverse effects; D004338:Drug Combinations; D004878:Ergotamine / Q000009:adverse effects; D004881:Ergotism / Q000150:complications*; D005260:Female; D016523:Foot Ulcer / Q000139:chemically induced / Q000188:drug therapy; D006801:Humans; D007383:Intermittent Claudication / Q000139:chemically induced* / Q000188:drug therapy; D007511:Ischemia / Q000139:chemically induced* / Q000188:drug therapy; D007866:Leg / Q000098:blood supply*; D008881:Migraine Disorders / Q000188:drug therapy; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use
chemical_list: D004338:Drug Combinations; D010975:Platelet Aggregation Inhibitors; C037330:caffeine, ergotamine drug combination; D002110:Caffeine; C041502:Migril; D004878:Ergotamine; D003501:Cyclizine