Terlipressin‐induced skin necrosis in cirrhotic patients—A case report and comprehensive literature review

<p dir="ltr">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...

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Main Author: Ashraf I. Ahmed (22045163) (author)
Other Authors: Muhammad Zain Kaleem (18021955) (author), Shahem Abbarh (17945564) (author), Haider Hussein Barjas (22155841) (author), Abdellatif Ismail (14182309) (author), Mhd Kutaiba Albuni (11721777) (author), Bisher Sawaf (4972819) (author)
Published: 2024
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author Ashraf I. Ahmed (22045163)
author2 Muhammad Zain Kaleem (18021955)
Shahem Abbarh (17945564)
Haider Hussein Barjas (22155841)
Abdellatif Ismail (14182309)
Mhd Kutaiba Albuni (11721777)
Bisher Sawaf (4972819)
author2_role author
author
author
author
author
author
author_facet Ashraf I. Ahmed (22045163)
Muhammad Zain Kaleem (18021955)
Shahem Abbarh (17945564)
Haider Hussein Barjas (22155841)
Abdellatif Ismail (14182309)
Mhd Kutaiba Albuni (11721777)
Bisher Sawaf (4972819)
author_role author
dc.creator.none.fl_str_mv Ashraf I. Ahmed (22045163)
Muhammad Zain Kaleem (18021955)
Shahem Abbarh (17945564)
Haider Hussein Barjas (22155841)
Abdellatif Ismail (14182309)
Mhd Kutaiba Albuni (11721777)
Bisher Sawaf (4972819)
dc.date.none.fl_str_mv 2024-09-29T09:00:00Z
dc.identifier.none.fl_str_mv 10.1002/ccr3.9141
dc.relation.none.fl_str_mv https://figshare.com/articles/journal_contribution/Terlipressin_induced_skin_necrosis_in_cirrhotic_patients_A_case_report_and_comprehensive_literature_review/30024292
dc.rights.none.fl_str_mv CC BY 4.0
info:eu-repo/semantics/openAccess
dc.subject.none.fl_str_mv Biomedical and clinical sciences
Clinical sciences
Pharmacology and pharmaceutical sciences
esophageal variceal bleed
esophageal varices
hepatorenal syndrome
skin necrosis
terlipressin
upper gastrointestinal bleeding
dc.title.none.fl_str_mv Terlipressin‐induced skin necrosis in cirrhotic patients—A case report and comprehensive literature review
dc.type.none.fl_str_mv Text
Journal contribution
info:eu-repo/semantics/publishedVersion
text
contribution to journal
description <p dir="ltr">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.</p><p dir="ltr">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.</p><h2>Other Information</h2><p dir="ltr">Published in: Clinical Case Reports<br>License: <a href="http://creativecommons.org/licenses/by/4.0/" target="_blank">http://creativecommons.org/licenses/by/4.0/</a><br>See article on publisher's website: <a href="https://dx.doi.org/10.1002/ccr3.9141" target="_blank">https://dx.doi.org/10.1002/ccr3.9141</a></p>
eu_rights_str_mv openAccess
id Manara2_0458f31e554badbe6539f51d1249c98d
identifier_str_mv 10.1002/ccr3.9141
network_acronym_str Manara2
network_name_str Manara2
oai_identifier_str oai:figshare.com:article/30024292
publishDate 2024
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spelling Terlipressin‐induced skin necrosis in cirrhotic patients—A case report and comprehensive literature reviewAshraf I. Ahmed (22045163)Muhammad Zain Kaleem (18021955)Shahem Abbarh (17945564)Haider Hussein Barjas (22155841)Abdellatif Ismail (14182309)Mhd Kutaiba Albuni (11721777)Bisher Sawaf (4972819)Biomedical and clinical sciencesClinical sciencesPharmacology and pharmaceutical sciencesesophageal variceal bleedesophageal variceshepatorenal syndromeskin necrosisterlipressinupper gastrointestinal bleeding<p dir="ltr">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.</p><p dir="ltr">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.</p><h2>Other Information</h2><p dir="ltr">Published in: Clinical Case Reports<br>License: <a href="http://creativecommons.org/licenses/by/4.0/" target="_blank">http://creativecommons.org/licenses/by/4.0/</a><br>See article on publisher's website: <a href="https://dx.doi.org/10.1002/ccr3.9141" target="_blank">https://dx.doi.org/10.1002/ccr3.9141</a></p>2024-09-29T09:00:00ZTextJournal contributioninfo:eu-repo/semantics/publishedVersiontextcontribution to journal10.1002/ccr3.9141https://figshare.com/articles/journal_contribution/Terlipressin_induced_skin_necrosis_in_cirrhotic_patients_A_case_report_and_comprehensive_literature_review/30024292CC BY 4.0info:eu-repo/semantics/openAccessoai:figshare.com:article/300242922024-09-29T09:00:00Z
spellingShingle Terlipressin‐induced skin necrosis in cirrhotic patients—A case report and comprehensive literature review
Ashraf I. Ahmed (22045163)
Biomedical and clinical sciences
Clinical sciences
Pharmacology and pharmaceutical sciences
esophageal variceal bleed
esophageal varices
hepatorenal syndrome
skin necrosis
terlipressin
upper gastrointestinal bleeding
status_str publishedVersion
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 Biomedical and clinical sciences
Clinical sciences
Pharmacology and pharmaceutical sciences
esophageal variceal bleed
esophageal varices
hepatorenal syndrome
skin necrosis
terlipressin
upper gastrointestinal bleeding