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Revista Colombiana de Reumatología
versión impresa ISSN 0121-8123
Resumen
TORRES, Fabio Andrés et al. Ergotism, a relatively unknown mimic of vasculitis: A case report and review of literature. Rev.Colomb.Reumatol. [online]. 2020, vol.27, n.4, pp.303-307. Epub 16-Ago-2021. ISSN 0121-8123. https://doi.org/10.1016/j.rcreu.2020.02.002.
Introduction:
Ergotism is a vasospasm that affects visceral and peripheral muscle arteries. Classically, symmetrical involvement of lower limb arteries is described, and is often associated with a history of chronic consumption of ergotamine derived medications (Cafergot). Case report: A 22 year-old healthy man with infectious mononucleosis syndrome, who presented with a sudden onset of paraesthesias in the lower limbs, as well as livedo reticularis. The initial diagnosis was a medium-sized vessel vasculitis (polyarteritis nodosa). The symptoms were preceded by the administration of Cafergot for headache treatment, and resolved spontaneously. The magnetic resonance angiography (MRA) of the lower limbs showed occlusion of peroneal arteries, with filiform distal flow. Other infectious, autoimmune and cardiovascular origins were ruled out.
Discussion:
Ergotism is an important differential diagnosis in the study of the patient with vasculitis, especially in acute onset presentations. Its treatment is the suspension of the causal drug, with vasodilator and surgical vascular procedures, if necessary.
Conclusions:
Ergotism is an imitator of vasculitis, especially in young patients with a history of difficult to control migraine. The concomitant administration of CYP3A4 inhibitors (mainly, protease inhibitors and macrolides) enhances the toxic effects of ergot.
Palabras clave : Ergotism; Vasculitis; Vasospasm; Polyarteritis nodosa; Vasodilators.