Ergotism is known to cause peripheral vascular ischemia. This case report describes the occurrence of peripheral gangrene in a thirty seven year old woman who had been taking a hydrogenated ergot alkaloid, ergoloid mesylates, 3 x 25 dr./24h, for nine years. Negative results from exhaustive clinical, labora tory and technical investigations and the disappearance of symptoms after with drawal of the drug compel the conclusion that chronic intake of ergoloid mesylates led to the vascular problems presented by the patient. Six months after the second amputation of necrotic toes the patient was painfree and showed no signs of recurring ischemia. The amputation would have healed sat isfactorily.
Merhoff GG, Porter J.: Ergot intoxication: Historical review and description of unusual clinical manifestations. Ann Surg180(5):773-779, 1974.
3.
Greene FL, Ariyan S., Stansel HL Jr: Mesenteric and peripheral vascular ischemia secondary to ergotism. Surgery81(2):176-179, 1977.
4.
Maples M., Mulherin JL, Harris J., et al: Arterial complications of ergotism. Am Surg47:224-227, 1981.
5.
Van den Berg E., Walterbusch G., Gotzen L., et al: Ergotism leading to threatened limb amputation or to death in two patients given heparin-dihydroergotamine prophylaxis . Lancet no. 4:955, 1982.
6.
Lane TV: Gangrene induced by methysergide and ergotamine. A case report.
7.
Franics H., Tyndall A., Webb J.: Severe vascular spasm due to erythromycin-ergotamine interaction. Clin Rheumatol3(2):243-246, 1984.
8.
Venter CP, Joubert PM, Buys AC: Severe peripheral ischaemia during concomitant use of beta blockers and ergot alkaloids. Br Med J289:288-289, 1984.
9.
Gelin M., Barroy JP, Dereume JP, et al: Artériopathie par intoxication à l'ergot. Acta Chir Belg74(4):401-406, 1977.
10.
Greenberg D. , Hallet J.: Lower extremity ischemia due to combined drug therapy for migraine. Postgrad Med72(4):103-105, 1982.
11.
Schram A., Sperling M.: Ergotamin-Schaden einst und heute. Munch Med Wochenschr125:492-494, 1983.
12.
Berde B., Sturmer E.: Ergot alkaloids and related compounds. In: Handbook of Experimental Pharmacology, vol. 79, ed. by Berde B, Schild MO.Berlin: Springer Verlag, 1978.
13.
Berde B.: Pharmacology of ergot alkaloids in clinical use. Med J Aust (Spec. Supple.) Nov. 4, 1978 , p. 3.
