Acute quadruple extremity compartment syndrome due to angio-oedema after polypharmacy overdose including olmesartan medoxomil, telmisartan and vildagliptin.

Autor: Kono Y; Department of Intensive Care Medicine, Kameda Medical Center, Kamogawa, Japan., Takimoto K; Department of Intensive Care Medicine, Kameda Medical Center, Kamogawa, Japan mm7706tk@gmail.com., Fujii M; Department of Intensive Care Medicine, Kameda Medical Center, Kamogawa, Japan., Hayashi Y; Department of Intensive Care Medicine, Kameda Medical Center, Kamogawa, Japan.
Jazyk: angličtina
Zdroj: BMJ case reports [BMJ Case Rep] 2024 Apr 02; Vol. 17 (4). Date of Electronic Publication: 2024 Apr 02.
DOI: 10.1136/bcr-2023-259485
Abstrakt: This case report describes a rare manifestation of acute compartment syndrome (ACS) involving all four extremities, precipitated by angio-oedema in a middle-aged woman who consumed an overdose of multiple medications: nifedipine, azelnidipine, amlodipine besylate, olmesartan medoxomil, telmisartan, esaxerenone and vildagliptin. She presented with haemodynamic instability, necessitating intubation. Despite stabilising haemodynamic parameters within 24 hours, she manifested escalating extremity oedema. At 52 hours after ingestion, mottled skin was observed, along with necrotic alterations in the swollen hands and compartment pressures exceeding 30 mm Hg in all extremities. ACS was diagnosed, leading to fasciotomies. The aetiology is postulated to be drug-induced angio-oedema, possibly intensified by the concurrent overdose of olmesartan medoxomil, telmisartan and vildagliptin, each of which has a risk of angio-oedema even at standard dosages. This scenario is a very rare case caused by drug-induced angio-oedema, which underscores the importance of vigilant monitoring to detect ACS in patients with progressing limb oedema.
Competing Interests: Competing interests: None declared.
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Databáze: MEDLINE
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