Korean J Gastroenterol.  2008 Jun;51(6):381-384.

A Case of Ischemic Skin Necrosis after Glypressin Therapy in Liver Cirrhosis

• Oh JE
• Ha JS
• Cho DH
• Yu GJ
• Shim SG

Abstract

Terlipressin is a synthetic analogue of vasopressin, which has been used in the treatment of acute variceal hemorrhage. In contrast to vasopressin, terlipressin can be administered as intermittent injections instead of continuous intravenous infusion. Thus, it has a less adverse reaction than vasopressin. We report a case of ischemic skin complication in a cirrhotic patient treated with terlipressin. A 71-year-old man with liver cirrhosis was admitted because of hematemesis and melena. He was commenced on terlipressin at a dose 1 mg every 6 hours for the treatment of varicieal bleeding. After 36 hours of treatment, skin blistering and ecchymosis was noted on the skin of his upper thigh, scrotal area and trunk. We found that terlipressin was a possible cause of ischemic skin complication based on the skin biopsy finding. Terlipressin may induce a complication of the ischemic event. In spite of rarity, special attention needs to paid on the peripheral ischemic complication of terlipressin.

Keyword

Terlipressin; Ischemic complications; Cirrhosis

MeSH Terms

Aged
Fatal Outcome
Hematemesis/diagnosis
Hemorrhage/drug therapy
Humans
Ischemia/*chemically induced/*pathology
Liver Cirrhosis/*complications
Lysine Vasopressin/administration & dosage/adverse effects/*analogs & derivatives/therapeutic use
Male
Melena/diagnosis
Necrosis
Skin/*blood supply/drug effects/*pathology
Vasoconstrictor Agents/administration & dosage/*adverse effects/therapeutic use