Terlipressin‐induced extensive skin necrosis: A case report and published work review

Lu, Ying‐Yi; Wei, Kai-Che; Wu, Chieh‐Shan

doi:10.1111/j.1346-8138.2012.01595.x

Cited by 10 publications

(6 citation statements)

References 3 publications

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“…The risk factors for ischaemic skin complications described in the literature include ischaemic disease, obesity, ascites, venous insufficiency, spontaneous bacterial peritonitis, hypotension, vasopressor drugs administered concomitantly, and continuous infusion of terlipressin [1,2] . Our patient presented with venous insufficiency and episodes of hypotension secondary to gastro-intestinal haemorrhage, which could cause tissue hypoxia.…”

Section: Discussionmentioning

confidence: 99%

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Terlipressin-related Ischaemic Necrosis of the Skin: A Rare Complication

Macedo

Cabral

Novais

et al. 2019

European Journal of Case Reports in Internal Medicine

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Terlipressin is used for the treatment of bleeding oesophageal varices and hepatorenal syndrome in patients with cirrhosis. Adverse effects are usually minimal. However, potentially serious side effects such as skin necrosis involving the extremities, scrotum, trunk and abdominal skin can rarely occur. Our patient had greater skin involvement than other described cases. We present the case of a patient with extensive skin necrosis, unrelated to the infusion site, in the lower and upper limbs, scrotum and abdomen after the use of terlipressin. Skin necrosis secondary to terlipressin is a rare complication and early identification is essential so the drug can be immediately suspended.LEARNING POINTSSkin necrosis secondary to terlipressin is a rare complication.Early identification is essential so the drug can be immediately suspended.Death is not directly related to the skin necrosis but to the secondary complications of advanced liver disease.

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Section: Discussionmentioning

confidence: 99%

“…The pathological anatomy of the lesions is non-specific and so is less useful for ruling out other vasculitic pathologies [2] . In our case, it was possible to identify epidermal necrosis.…”

Section: Discussionmentioning

confidence: 99%

Terlipressin-related Ischaemic Necrosis of the Skin: A Rare Complication

Macedo

Cabral

Novais

et al. 2019

European Journal of Case Reports in Internal Medicine

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“…More specifically, our patient developed skin lesions 14 h after terlipressin treatment initiation, whereas in all but one (time lag not specified, no histology available [ 6 ]) of the cases found in PubMed the lesions developed up to 264 h later. Moreover, in the 2 cases where lesions occurred within 24 h following treatment initiation [ 1 , 4 ], ECM was detected. Although ischemic skin lesions related to terlipressin administration usually affect the extremities (fingers, scrotum, lower legs and toes), our patient’s extremities were spared.…”

Section: Discussionmentioning

confidence: 99%

“…The majority of cases of skin necrosis associated with terlipressin use occurred in alcoholic cirrhotics suffering from hepatorenal syndrome or variceal bleeding. Several predisposing factors for skin necrosis in these patients have been reported, including obesity [ 3 , 5 ], hypovolemia [ 4 , 5 ], use of vasoconstrictive agents (apart from terlipressin) [ 2 ], ischemic vascular disease [ 2 , 5 ] and sepsis [ 2 ]. Our patient was non-alcoholic, obese, and hypovolemic at presentation.…”

Section: Discussionmentioning

confidence: 99%

Embolia cutis medicamentosa: an unusual adverse reaction to terlipressin

Gatos-Gatopoulos¹,

Kostantoudakis

Panayiotides

et al. 2017

aog

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“…Furthermore, because of the signs of liver dysfunction and the history of alcohol abuse, which suggested variceal bleeding, the patient received terlipressin, a splanchnic vasoconstrictor that may have reduced microcirculatory perfusion, further contributing to the local ischemia [4]. Although cutaneous necrosis following terlipressin treatment has been reported [5], this is the first reported case of a possible association with acute esophageal necrosis.…”

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confidence: 99%