[Ergotism secondary to ergotamine-ritonavir association. Report of three cases].

Abstract

Ergotism is a complication of the acute intoxication or chronic abuse of ergot derivatives. It may be manifested by a vasomotor syndrome with peripheral vascular disease frequently involving extremities. We report three patients infected with human immunodeficiency virus (HIV), in antiretroviral treatment (ART) that included a protease inhibitor as ritonavir, and had received self-medicated ergotamine. They developed symptoms of peripheral vascular disease and the physical examination showed no arterial pulses in the affected vessels. Arterial Doppler confirmed signs of diffuse arterial spasm in all of them. An arteriography was performed to the second patient and it showed obliteration of the distal sector of the ulnar and radial arteries. Ergotism secondary to ergotamine-ritonavir association was diagnosed. Patients were treated discontinuing the administration of involved drugs, arterial vasodilators and prophylactic anticoagulation, with marked improvement of symptoms.

• Authors: Santiago Acle, Federico Roca, Mariela Vacarezza, Alfredo Álvarez Rocha
• Journal: Revista medica de Chile (Rev Med Chil) Vol. 139 Issue 12 Pg. 1597-600 (Dec 2011) ISSN: 0717-6163 [Electronic] Chile
• Vernacular Title: Ergotismo secundario a la asociación ergotamina-ritonavir. A propósito de 3 casos.
• PMID: 22446707 (Publication Type: Case Reports, English Abstract, Journal Article)

Chemical References

• HIV Protease Inhibitors
• Vasoconstrictor Agents
• Ritonavir
• Ergotamine

Topics

• Adult
• Drug Interactions
• Drug Therapy, Combination (adverse effects)
• Ergotamine (poisoning)
• Ergotism (etiology)
• Female
• HIV Infections (drug therapy)
• HIV Protease Inhibitors (adverse effects)
• Humans
• Male
• Middle Aged
• Peripheral Arterial Disease (chemically induced)
• Ritonavir (adverse effects)
• Vasoconstrictor Agents (poisoning)