[Ergotism and HIV].
Ergotism is a complication of acute intoxication and/or chronic abuse of ergot derivatives. It expresses itself through a vasomotor syndrome with peripheral vascular disease which frequently involves extremities. We report four cases of HIV-1 infected patients treated with antiretroviral drugs including boosted-protease inhibitors who had self-treated themselves with ergotamine. They developed peripheral vascular disease symptoms and their pulses where diminished or absent in the physical examination. Arterial Doppler confirmed diffused arterial spasm in two of them. Ergotism following ergotamine-protease inhibitors association was diagnosed. Patients were treated through the discontinuity of involved drugs (protease inhibitors and ergotamine), calcium blockers; antithrombotic prophylaxis with enoxaparine, antiaggregant therapy with acetylsalicylic acid, and one of them received pentoxifylline and vasodilator prostaglandins infusion, with amelioration of the symptoms. We discuss the clinical presentation of this drug interaction, difficult to diagnose properly without a strong suspicion of its existence.
Servicio de Clínica Médica, Hospital Británico de Buenos Aires, Buenos Aires, Argentina.
Bárbara C
BC
Finn
Sabrina
S
Vadalá
Ana
A
Meraldi
Julio E
JE
Bruetman
Jorge V
JV
Martínez
Pablo
P
Young
D058646:Adrenergic alpha-1 Receptor Agonists / Q000009:adverse effects*; D000328:Adult; D004347:Drug Interactions; D004359:Drug Therapy, Combination / Q000009:adverse effects; D004878:Ergotamine / Q000009:adverse effects*; D004881:Ergotism / Q000209:etiology*; D005260:Female; D015658:HIV Infections / Q000188:drug therapy*; D017320:HIV Protease Inhibitors / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019438:Ritonavir / Q000009:adverse effects*
D058646:Adrenergic alpha-1 Receptor Agonists; D017320:HIV Protease Inhibitors; D019438:Ritonavir; D004878:Ergotamine
ergotamine; ergotism; migraine; ritonavir