Ergotamine use in severe diabetic autonomic neuropathy

Toh, V., Duncan, E., Lewis, N., Fichter, L. and Matthews, D. R. (2006) Ergotamine use in severe diabetic autonomic neuropathy. Diabetic Medicine, 23 5: 574-576. doi:10.1111/j.1464-5491.2006.01844.x


Author Toh, V.
Duncan, E.
Lewis, N.
Fichter, L.
Matthews, D. R.
Title Ergotamine use in severe diabetic autonomic neuropathy
Journal name Diabetic Medicine   Check publisher's open access policy
ISSN 0742-3071
1464-5491
Publication date 2006-05-01
Sub-type Article (original research)
DOI 10.1111/j.1464-5491.2006.01844.x
Volume 23
Issue 5
Start page 574
End page 576
Total pages 3
Editor Sally M. Marshall
Place of publication Oxford, United Kingdom
Publisher Wiley-Blackwell
Language eng
Subject 110306 Endocrinology
Abstract 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.
Keyword Endocrinology & Metabolism
postural hypotension
diabetes
autonomic neuropathy
fludrocortisone
midodrine
octreotide
erythropoieten
ergotamine
caffeine
Orthostatic Hypotension
History
Q-Index Code C1
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Excellence in Research Australia (ERA) - Collection
UQ Diamantina Institute Publications
 
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Created: Sat, 26 Jan 2008, 02:49:57 EST