Year 2021 / Volume 113 / Number 8
Letter
Ischemic skin necrosis secondary to the use of terlipressin

617

DOI: 10.17235/reed.2020.7467/2020

María Reyes Busta Nistal, Natalia Mora Cuadrado, Luis Fernández Salazar,

Abstract
We present the case of a 45-year-old male with alcoholic liver cirrhosis Child-Pugh C and chronic left lower limb lymphedema, hospitalized because of ascites and renal impairment (Cr 2.33 mg/dl). He received intravenous albumin and terlipressin (1 mg every 4h) for suspected hepatorenal syndrome. After 48 hours, purpuric skin lesions appeared on both lower extremities, scrotum and umbilical hernia. Renal function improved (Cr 0.49 mg/dl). Nevertheless, terlipressin was discontinued as the skin lesions worsened due to epidermal detachment, and oral sildenafil was administered at 50 mg twice per day. The left lower limb was severely affected with extensive skin and soft tissue necrosis, which led to supracondylar amputation. All the other lesions had a satisfactory evolution, with reepithelialization of the damaged areas.
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References
1) The European Association for the Study of the Liver. EASL Clinical Practice Guidelines for the management of patients with decompensated cirrhosis. J Hepatol (2018).
2) Chiang C.-W. et al.: Terlipressin-induced peripheral cyanosis. Am J Case Rep, 2019; 20: 5-9.
3) Ozel Coskun B.D. et al.: Terlipressin-induced ischemic skin necrosis. Am J Case Rep, 2014; 15: 476-479
4) Iván Herrera, María Leiva-Salinas, et al. Necrosis cutánea extensa por Terlipresina. Gastroenterol Hepatol. 2015;38 (1):12-23.
5) Iglesias E et al. Cutaneous necrosis secondary to terlipressin therapy. A rare but serious side effect. Case report and literature review". Rev Esp Enferm Dig. 2017 May;109(5):380-382. doi: 10.17235/reed.2017.4466/2016.
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Busta Nistal M, Mora Cuadrado N, Fernández Salazar L. Ischemic skin necrosis secondary to the use of terlipressin. 7467/2020


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Publication history

Received: 11/08/2020

Accepted: 14/09/2020

Online First: 03/12/2020

Published: 28/07/2021

Article Online First time: 114 days

Article editing time: 351 days


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