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 “epidermal necros...
Source: The Poison Review - Category: Toxicology Authors: Leon Tags: Medical adverse drug reaction dilantin phenytoin phosphenytoin purple glove syndrome soft tissue Source Type: news
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