Ergotamine use in severe diabetic autonomic neuropathy.
BACKGROUND: Symptomatic postural hypotension in diabetes is uncommon. When it does occur, it can prove debilitating and difficult to treat. We report here the therapeutic challenges encountered in managing a patient with severe postural hypotension secondary to diabetes-related autonomic neuropathy....
| Main Authors: | , , , , |
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| Format: | Journal article |
| Language: | English |
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2006
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| _version_ | 1826264447388221440 |
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| author | Toh, V Duncan, E Lewis, N Fichter, L Matthews, DR |
| author_facet | Toh, V Duncan, E Lewis, N Fichter, L Matthews, DR |
| author_sort | Toh, V |
| collection | OXFORD |
| description | BACKGROUND: Symptomatic postural hypotension in diabetes is uncommon. When it does occur, it can prove debilitating and difficult to treat. We report here the therapeutic challenges encountered in managing a patient with severe postural hypotension secondary to diabetes-related autonomic neuropathy. CASE REPORT: A 69-year-old gentleman with a 23-year history of Type 1 diabetes mellitus and multiple microvascular complications was admitted with symptoms of severe postural hypotension. Cardiovascular autonomic testing confirmed the presence of severe autonomic neuropathy. He failed to respond to non-pharmacological measures, fludrocortisone, midodrine, octreotide, erythropoietin and increased caffeine intake. Eventually he was commenced on half a Cafergot suppository (giving him a dose of ergotamine 1 mg and caffeine 50 mg) which resulted in dramatic clinical improvement. CONCLUSION: Ergotamine may be considered in refractory cases of postural hypotension. |
| first_indexed | 2024-03-06T20:07:57Z |
| format | Journal article |
| id | oxford-uuid:298b2048-6aaf-478f-a4cd-c85f58f6828d |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-06T20:07:57Z |
| publishDate | 2006 |
| record_format | dspace |
| spelling | oxford-uuid:298b2048-6aaf-478f-a4cd-c85f58f6828d2022-03-26T12:19:49ZErgotamine use in severe diabetic autonomic neuropathy.Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:298b2048-6aaf-478f-a4cd-c85f58f6828dEnglishSymplectic Elements at Oxford2006Toh, VDuncan, ELewis, NFichter, LMatthews, DRBACKGROUND: Symptomatic postural hypotension in diabetes is uncommon. When it does occur, it can prove debilitating and difficult to treat. We report here the therapeutic challenges encountered in managing a patient with severe postural hypotension secondary to diabetes-related autonomic neuropathy. CASE REPORT: A 69-year-old gentleman with a 23-year history of Type 1 diabetes mellitus and multiple microvascular complications was admitted with symptoms of severe postural hypotension. Cardiovascular autonomic testing confirmed the presence of severe autonomic neuropathy. He failed to respond to non-pharmacological measures, fludrocortisone, midodrine, octreotide, erythropoietin and increased caffeine intake. Eventually he was commenced on half a Cafergot suppository (giving him a dose of ergotamine 1 mg and caffeine 50 mg) which resulted in dramatic clinical improvement. CONCLUSION: Ergotamine may be considered in refractory cases of postural hypotension. |
| spellingShingle | Toh, V Duncan, E Lewis, N Fichter, L Matthews, DR Ergotamine use in severe diabetic autonomic neuropathy. |
| title | Ergotamine use in severe diabetic autonomic neuropathy. |
| title_full | Ergotamine use in severe diabetic autonomic neuropathy. |
| title_fullStr | Ergotamine use in severe diabetic autonomic neuropathy. |
| title_full_unstemmed | Ergotamine use in severe diabetic autonomic neuropathy. |
| title_short | Ergotamine use in severe diabetic autonomic neuropathy. |
| title_sort | ergotamine use in severe diabetic autonomic neuropathy |
| work_keys_str_mv | AT tohv ergotamineuseinseverediabeticautonomicneuropathy AT duncane ergotamineuseinseverediabeticautonomicneuropathy AT lewisn ergotamineuseinseverediabeticautonomicneuropathy AT fichterl ergotamineuseinseverediabeticautonomicneuropathy AT matthewsdr ergotamineuseinseverediabeticautonomicneuropathy |