Drug points: Erythromelalgia induced by possible calcium channel blockade by ciclosporin

Thami, Gurvinder P.

doi:10.1136/bmj.326.7395.910

Cited by 22 publications

(6 citation statements)

References 4 publications

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“…During this time, the patient developed erythema, edema, and tenderness of the fingers and toes. After discontinuation of the cyclosporine, the symptoms temporarily improved, but recurred when cyclosporine was restarted [15]. Based on these previous findings and the reported case above, secondary erythromelalgia can be alleviated when a causative medication is discontinued or decreased in dosage.…”

Section: Discussionmentioning

confidence: 86%

“…Reported triggers include heat, pressure, extended dependent positioning of the affected limb (i.e. standing), exercise, emotions, stress, alcohol, spicy food, exposure to chronic vibration, and vasodilatory medications [15-16]. Symptoms may be episodic, with attacks lasting minutes to days, and can often be relieved by elevation, submersion of the affected limb in cold water or ice, smoking cessation, properly fitting footwear, and avoidance of vasodilatory medications [6].…”

Section: Discussionmentioning

confidence: 99%

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Cyclosporine-induced Erythromelalgia

Bibb¹,

Winter²,

Leicht³

2018

Cureus

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Erythromelalgia is a neurovascular disorder which causes pain, swelling, erythema, and warmth of the distal extremities. Primary disease is due to a genetic mutation in the SCN9A gene, but secondary erythromelalgia can be the consequence of a variety of underlying etiologies, including drug and toxin exposures. The disease is rare, occurring in only 1.3 out of every 100,000 in the United States, and symptoms can vary significantly in severity and presentation. Therefore, it can be difficult to recognize the disorder, identify the source, and promptly treat the condition. We report a reversible cause of erythromelalgia induced by the use of oral cyclosporine. This correlation is poorly documented in literature, with limited accounts identifying an association between erythromelalgia and cyclosporine. As drug-induced erythromelalgia represents a reversible cause of disease, physicians should obtain a detailed medication history during the diagnostic workup, specifically inquiring about the use of cyclosporine.

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Section: Discussionmentioning

confidence: 86%

Section: Discussionmentioning

confidence: 99%

Cyclosporine-induced Erythromelalgia

Bibb¹,

Winter²,

Leicht³

2018

Cureus

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“…Erythromelalgia is a symptom complex of painful inflammatory vasodilatation of the extremities rarely induced by calcium channel blockers and cyclosporin. It typically causes marked erythema, oedema and tenderness [6]. Calcium channel blockers would not be expected to improve its symptoms.…”

Section: Discussionmentioning

confidence: 99%

Leg bone pain syndrome in a patient with ulcerative colitis treated with cyclosporin

2007

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“…1,6–8,18 The patient’s erythromelalgia worsened with calcium channel blockers, contrary to its typical use as a third-line medication, consistent with previous reports. 19 There are a handful of case reports and cohort studies that report on the success of IVIG in secondary erythromelalgia. 20,21…”

Section: Discussionmentioning

confidence: 99%

“…1,[6][7][8]18 The patient's erythromelalgia worsened with calcium channel blockers, contrary to its typical use as a third-line medication, consistent with previous reports. 19 There are a handful of case reports and cohort studies that report on the success of IVIG in secondary erythromelalgia. 20,21 When standard treatments fail, IVIG can be considered due to potential autoimmune abnormalities in patients with secondary erythromelalgia.…”

Section: Discussionmentioning

confidence: 99%