Reactions 447 - 17 Apr 1993

SVasopressin

Fatal rhabdomyolysis with continuous IVadministration in an elderly patient: case report

A 69-year-old man with acute oesophageal variceal bleedingdeveloped fatal rhabdomyolysis 28 hours after he startedtreatment with a continuous IV infusion of vasopressin 0.4U/min. At this time, he was also given IV cimetidine, and asmall amount of 2% nitroglycerin ointment was applied to hischest. The patient had a 7-year history of transfusion-associated chronic active hepatitis and had been hospitalised 7months earlier for a bleeding gastric ulcer. The man wasadmitted with haematochezia and abdominal pain. There wasblood in the rectal vault and stomach. Anoesophagogastroduodenoscopy revealed grade III varices withmultiple red spots. 22 hours after starting vasopressintreatment, the patient observed generalised myalgia andecchymotic skin. Vasopressin was tapered off over the next 6hours, but the patient’s urine was found to contain myoglobin,and rhabdomyolysis was diagnosed. The man suffered acardiopulmonary arrest and died. No autopsy was permittedPierce ST, et al. Rhabdomyolysis associated with the use of intravenousvasopressin. American Journal of Gastroenterology 88: 424-427, Mar 1993 -USA 800189706

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Reactions 17 Apr 1993 No. 4470114-9954/10/0447-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved