Terlipressin‐induced skin necrosis in cirrhotic patients—A case report and comprehensive literature review
Key Clinical Message The occurrence of terlipressin‐induced skin necrosis in cirrhotic patients is a rare but serious adverse event that warrants further investigation. Clinicians should be aware of this potential complication in cirrhotic patients receiving terlipressin therapy and closely monitor...
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| Format: | Article |
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Wiley
2024-10-01
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| Series: | Clinical Case Reports |
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| Online Access: | https://doi.org/10.1002/ccr3.9141 |
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| author | Ashraf I. Ahmed Muhammad Zain Kaleem Shahem Abbarh Haider Hussein Barjas Abdellatif Ismail Mhd Kutaiba Albuni Bisher Sawaf |
| author_facet | Ashraf I. Ahmed Muhammad Zain Kaleem Shahem Abbarh Haider Hussein Barjas Abdellatif Ismail Mhd Kutaiba Albuni Bisher Sawaf |
| author_sort | Ashraf I. Ahmed |
| collection | DOAJ |
| description | Key Clinical Message The occurrence of terlipressin‐induced skin necrosis in cirrhotic patients is a rare but serious adverse event that warrants further investigation. Clinicians should be aware of this potential complication in cirrhotic patients receiving terlipressin therapy and closely monitor for any signs of skin necrosis. Early recognition and prompt intervention are crucial in preventing further complications and improving patient outcomes. Further research is needed to better understand the risk factors associated with terlipressin‐induced skin necrosis and to develop effective preventive strategies. Overall, healthcare providers should exercise caution when prescribing terlipressin to cirrhotic patients, weighing the potential benefits against the risks of this rare but significant adverse event. Abstract Terlipressin is commonly used to manage conditions related to portal hypertension, such as hepatorenal syndrome and esophageal variceal bleeding. Despite its therapeutic benefits, terlipressin can rarely lead to severe ischemic complications involving the skin vasculature, known as terlipressin‐induced skin necrosis. We present a 50‐year‐old male with cirrhosis and acute variceal bleeding who developed skin necrosis following terlipressin administration. We performed a comprehensive review of the literature by analyzing 18 case reports/case series comprising 22 cirrhotic patients with terlipressin‐induced skin necrosis. Among these individuals, we found a mean age of 51 years with a male predominance (78%). Further analysis showed that the onset of skin necrosis ranged from 2 to 5 days post‐terlipressin initiation, with bolus administration being predominant (85.7%). The underlying pathophysiological mechanisms of terlipressin‐induced skin ischemia are still elusive but primarily attributed to the vasoconstrictive and thrombogenic effects. Management involves terlipressin discontinuation and supportive care. Physicians should be aware of this potential complication in patients receiving terlipressin and closely observe for any signs of skin rash. |
| format | Article |
| id | doaj-art-6a31caa0679049cdac3a610e46689fb9 |
| institution | OA Journals |
| issn | 2050-0904 |
| language | English |
| publishDate | 2024-10-01 |
| publisher | Wiley |
| record_format | Article |
| series | Clinical Case Reports |
| spelling | doaj-art-6a31caa0679049cdac3a610e46689fb92025-08-20T01:54:16ZengWileyClinical Case Reports2050-09042024-10-011210n/an/a10.1002/ccr3.9141Terlipressin‐induced skin necrosis in cirrhotic patients—A case report and comprehensive literature reviewAshraf I. Ahmed0Muhammad Zain Kaleem1Shahem Abbarh2Haider Hussein Barjas3Abdellatif Ismail4Mhd Kutaiba Albuni5Bisher Sawaf6College of Medicine, QU Health, Qatar University Doha QatarCollege of Medicine, QU Health, Qatar University Doha QatarDepartment of Internal Medicine Hamad Medical Corporation Doha QatarDepartment of Internal Medicine Hamad Medical Corporation Doha QatarDepartment of Internal Medicine University of Maryland Medical Center‐Midtown Campus Baltimore Maryland USADepartment of Internal Medicine Trihealth Good Samaritan Hospital Cincinnati Ohio USADepartment of Internal Medicine Hamad Medical Corporation Doha QatarKey Clinical Message The occurrence of terlipressin‐induced skin necrosis in cirrhotic patients is a rare but serious adverse event that warrants further investigation. Clinicians should be aware of this potential complication in cirrhotic patients receiving terlipressin therapy and closely monitor for any signs of skin necrosis. Early recognition and prompt intervention are crucial in preventing further complications and improving patient outcomes. Further research is needed to better understand the risk factors associated with terlipressin‐induced skin necrosis and to develop effective preventive strategies. Overall, healthcare providers should exercise caution when prescribing terlipressin to cirrhotic patients, weighing the potential benefits against the risks of this rare but significant adverse event. Abstract Terlipressin is commonly used to manage conditions related to portal hypertension, such as hepatorenal syndrome and esophageal variceal bleeding. Despite its therapeutic benefits, terlipressin can rarely lead to severe ischemic complications involving the skin vasculature, known as terlipressin‐induced skin necrosis. We present a 50‐year‐old male with cirrhosis and acute variceal bleeding who developed skin necrosis following terlipressin administration. We performed a comprehensive review of the literature by analyzing 18 case reports/case series comprising 22 cirrhotic patients with terlipressin‐induced skin necrosis. Among these individuals, we found a mean age of 51 years with a male predominance (78%). Further analysis showed that the onset of skin necrosis ranged from 2 to 5 days post‐terlipressin initiation, with bolus administration being predominant (85.7%). The underlying pathophysiological mechanisms of terlipressin‐induced skin ischemia are still elusive but primarily attributed to the vasoconstrictive and thrombogenic effects. Management involves terlipressin discontinuation and supportive care. Physicians should be aware of this potential complication in patients receiving terlipressin and closely observe for any signs of skin rash.https://doi.org/10.1002/ccr3.9141esophageal variceal bleedesophageal variceshepatorenal syndromeskin necrosisterlipressinupper gastrointestinal bleeding |
| spellingShingle | Ashraf I. Ahmed Muhammad Zain Kaleem Shahem Abbarh Haider Hussein Barjas Abdellatif Ismail Mhd Kutaiba Albuni Bisher Sawaf Terlipressin‐induced skin necrosis in cirrhotic patients—A case report and comprehensive literature review Clinical Case Reports esophageal variceal bleed esophageal varices hepatorenal syndrome skin necrosis terlipressin upper gastrointestinal bleeding |
| title | Terlipressin‐induced skin necrosis in cirrhotic patients—A case report and comprehensive literature review |
| title_full | Terlipressin‐induced skin necrosis in cirrhotic patients—A case report and comprehensive literature review |
| title_fullStr | Terlipressin‐induced skin necrosis in cirrhotic patients—A case report and comprehensive literature review |
| title_full_unstemmed | Terlipressin‐induced skin necrosis in cirrhotic patients—A case report and comprehensive literature review |
| title_short | Terlipressin‐induced skin necrosis in cirrhotic patients—A case report and comprehensive literature review |
| title_sort | terlipressin induced skin necrosis in cirrhotic patients a case report and comprehensive literature review |
| topic | esophageal variceal bleed esophageal varices hepatorenal syndrome skin necrosis terlipressin upper gastrointestinal bleeding |
| url | https://doi.org/10.1002/ccr3.9141 |
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