Nicolau Syndrome Due to Diclofenac Injection: Case Report

Turan, Hakan; Turan, Ayşegül

doi:10.5336/medsci.2010-22303

Cited by 3 publications

(8 citation statements)

References 8 publications

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“…The chance‐adjusted agreement between the two investigators on the application of the inclusion and exclusion criteria was 0.88. A total of 45 eligible reports 6‐50 published between 1996 and 2019 in English (N = 44) or Spanish (N = 1) were identified. The reports were primarily (N = 41, 91%) from Europe (Turkey, N = 17; Italy, N = 4; Belgium, N = 1; Germany, N = 1; Switzerland, N = 1) and Asia (India, N = 9; South Korea, N = 5; China, N = 1; Israel, N = 1; Qatar, N = 1).…”

Section: Resultsmentioning

confidence: 99%

“…The aforementioned 45 reports included 62 previously healthy subjects (40 females and 22 males aged from 13 to 81, median 57 years) with Nicolau syndrome occurring after intramuscular 6‐11,13‐50 or local 12 injection of a non‐steroidal anti‐inflammatory drug, as shown in Table 1. The vast majority of cases (N = 53; 85%) occurred following administration of diclofenac.…”

Section: Resultsmentioning

confidence: 99%

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Nicolau syndrome caused by non‐steroidal anti‐inflammatory drugs: Systematic literature review

Lardelli

Jermini

Milani

et al. 2020

Int. J. Clin. Pract.

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Aim Intramuscular or, more rarely, local drug injection is occasionally followed by immediate local pain, livedoid skin lesions and, some days later, the development of ischemic lesions. This very uncommon but potentially severe reaction, termed Nicolau syndrome, is traditionally associated with bismuth and β‐lactam antimicrobials. The aim of this report was to review the literature associating Nicolau syndrome with the administration of non‐steroidal anti‐inflammatory drugs. Methods The National Library, Excerpta Medica, Web of Science and Cochrane library databases were used. Results Sixty‐two cases (40 females and 22 males aged from 13 to 81, median 57 years) of Nicolau syndrome were published after 1992. Fifty‐three cases occurred after diclofenac. The remaining nine cases were associated with ketoprofen (N = 2), ketorolac (N = 2), phenylbutazone (N = 2), etofenamate (N = 1), ibuprofen (N = 1) and piroxicam (N = 1). Conclusion Although Nicolau syndrome is extremely uncommon, physicians must be aware of this complication after intramuscular administration of non‐steroidal anti‐inflammatory drugs and should avoid unnecessary injections.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Nicolau syndrome caused by non‐steroidal anti‐inflammatory drugs: Systematic literature review

Lardelli

Jermini

Milani

et al. 2020

Int. J. Clin. Pract.

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show abstract

“…Sekonder enfeksiyon da görü-lebilmektedir. 1,4 Hastaların çoğunluğunda lezyon, yerinde atrofik skar veya pigmentasyon bırakarak iyileşmek-tedir. Bazı hastalarda hipoestezi, parapleji, sfinkter yetmezliği veya sepsis gibi komplikasyonlar izlenebilmektedir.…”

Section: Olgu Sunumuunclassified

“…Bazı hastalarda hipoestezi, parapleji, sfinkter yetmezliği veya sepsis gibi komplikasyonlar izlenebilmektedir. 1,4,6 Hastalığın spesifik bir tedavisi yoktur. Lezyon yerinin debridmanı, ağrı kontrolü, yara örtüleri, antibiyotik, antikoagülan ve vazoaktif tedavi (pentoksifilin) uygulanması gibi konservatif tedaviler uygulanmaktadır.…”

Section: Olgu Sunumuunclassified

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Nicolau Syndrome Due to Diclofenac Injection: Case Report

İyidal¹,

Kılıç²

2017

Turkiye Klinikleri J Dermatol

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Coincidence of Nicolau Syndrome and Rhabdomyolysis: Report of a Forensic Autopsy Case and Review of the Literature

Arslan

Melez²,

Akçay³

et al. 2016

Journal of Forensic Sciences

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Nicolau syndrome (NS) is a dermatological adverse reaction of intramuscular injections and is caused by several mechanisms. The etiopathogenesis remains unclear, and several hypotheses have suggested a vascular origin. Rhabdomyolysis (RM) is the destruction of striated muscle, with the subsequent release of muscle cell contents into circulation. NS and RM diagnoses may overlap. Herein, we present the autopsy findings of a 40-year-old female with NS complicated with RM. On clinical follow-up, creatine kinase (CK) was 7146 IU/L, and urea and creatinine levels were elevated on the third day after intramuscular diclofenac injection. Possible ischemic process triggered the RM and subsequent acute renal failure. The opportunity for an early diagnosis was missed because the patient delayed seeking medical aid. The prognosis worsened, and the patient died due to secondary sepsis. Early diagnosis of NS before the occurrence of complications is the most important issue in patient education and can be life-saving.

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Nicolau Syndrome Due to Diclofenac Injection: Case Report

Cited by 3 publications

References 8 publications

Nicolau syndrome caused by non‐steroidal anti‐inflammatory drugs: Systematic literature review

Nicolau syndrome caused by non‐steroidal anti‐inflammatory drugs: Systematic literature review

Nicolau Syndrome Due to Diclofenac Injection: Case Report

Coincidence of Nicolau Syndrome and Rhabdomyolysis: Report of a Forensic Autopsy Case and Review of the Literature

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