Definitive paper on phenytoin/phosphenytoin-associated purple glove syndrome

Purple glove syndrome (fda.gov) 4.5 out of 5 stars Purple Glove Syndrome after Phenytoin or Fosphenytoin Administration: Review of Reported Cases and Recommendations for Prevention. Garbovsky LA et al. J Med Toxicol 2015 Dec;11:445-459. Abstract Purple glove syndrome (PGS) is an uncommon adverse drug reaction to parenteral administration of phenytoin or fosphenytoin marked by severe progressive soft tissue discoloration, swelling and pain in the distal extremity into which the drug was infused. This extremely well done and comprehensive paper will tell you all you need to know (well, probably more than you need to know) about our understanding of the syndrome to date. The authors reviewed all retrievable cases reported in the medical literature. They identified 82 cases of PGS associated with parenteral phenytoin, and 5 associated with parenteral phosphenytoin published between 1984 and 2015. They found an additional 2 cases possibly associated with oral phenytoin exposure, although one of the cases involved an inadvertent overdose in a patient who had also received the drug parenterally. PGS tends to progress in 3 stages: pain, discoloration and swelling around the site of infusion increasing signs and symptoms with sloughing, blistering and necrosis neuromuscular manifestations (paresthesia, weakness) These manifestations can resolve, or progress to limb ischemia and necrosis requiring skin grafting or amputation. Pathological specimens can show “epid...
Source: The Poison Review - Category: Toxicology Authors: Tags: Medical adverse drug reaction dilantin phenytoin phosphenytoin purple glove syndrome soft tissue Source Type: news

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Source: Anaesthesia, Critical Care and Pain Medicine - Category: Anesthesiology Source Type: research
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Source: Medical Science Monitor - Category: Research Tags: Med Sci Monit Source Type: research
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Source: Acta Medica Portuguesa - Category: General Medicine Tags: Acta Med Port Source Type: research
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Source: Acta Medica Portuguesa - Category: General Medicine Tags: Acta Med Port Source Type: research
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Source: Praxis - Category: General Medicine Authors: Tags: Praxis (Bern 1994) Source Type: research
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