Manifold manifestations of ergotism.
Vasospastic side effects leading to organic manifestations are rare in ergotamine therapy. To our knowledge, combinations of more than two signs of ergotism have rarely been described in the literature so far. We present a 65-year-old male patient who as a consequence of severe migraine had developed ergotamine abuse. He was admitted to our hospital after one week of increasing abdominal pain. During laparotomy, necrotic areas of the small intestine and the sigmoid colon were resected, which on histopathologic examination revealed severe hypertrophy of the smooth musculature of mesenteric arteries, resulting from chronic vasospasms. Postoperatively, the patient developed ischaemia of the limbs which was confirmed by angiography. Before death, the patient also showed ischaemic signs in the acrae and necrosis of the tongue.
Payne
B
B
Division of Surgery, Spital Zollikerberg, Zurich.
Sasse
B
B
Franzen
D
D
Hailemariam
S
S
Gemsenjäger
E
E
D000368:Aged; D003106:Colon / Q000000981:diagnostic imaging / Q000473:pathology; D003937:Diagnosis, Differential; D004878:Ergotamine / Q000009:adverse effects*; D004881:Ergotism / Q000175:diagnosis* / Q000209:etiology / Q000473:pathology; D017809:Fatal Outcome; D006801:Humans; D006984:Hypertrophy; D007421:Intestine, Small / Q000000981:diagnostic imaging / Q000473:pathology; D008297:Male; D008881:Migraine Disorders / Q000188:drug therapy*; D009336:Necrosis; D011859:Radiography; D019966:Substance-Related Disorders; D000267:Tissue Adhesions / Q000473:pathology; D014662:Vasoconstrictor Agents / Q000009:adverse effects*
D014662:Vasoconstrictor Agents; D004878:Ergotamine