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Szeliga Adrianna, Spyt Dominika, Kasinowicz Mateusz. Purple glove syndrome. Journal of Education, Health and Sport. 2019;9(8):298-305. eISNN 2391-8306. DOI http://dx.doi.org/10.5281/zenodo.3374299 http://ojs.ukw.edu.pl/index.php/johs/article/view/7306 The journal has had 5 points in Ministry of Science and Higher Education parametric evaluation. § 8. 2) and § 12. 1. 2) 22.02.2019. © The Authors 2019; This article is published with open access at Licensee Open Journal Systems of Kazimierz Wielki University in Bydgoszcz, Poland Open Access. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author (s) and source are credited. This is an open access article licensed under the terms of the Creative Commons Attribution Non commercial license Share alike. (http://creativecommons.org/licenses/by-nc-sa/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. The authors declare that there is no conflict of interests regarding the publication of this paper. Received: 10.08.2019. Revised: 20.08.2019. Accepted: 22.08.2019. Purple glove syndrome Adrianna Szeliga, e-mail: adria.szeliga@gmail.com ORCID: 0000-0002-3567-051X Dominika Spyt, e-mail: dominikaspyt3@gmail.com ORCID: 0000-0002-1993-2639 Mateusz Kasinowicz, e-mail: matkasinowicz@gmail.com ORCID: 0000-0001-6036-3450 Wydział Lekarski, Collegium Medicum im. Ludwika Rydygiera w Bydgoszczy, UMK w Toruniu Abstract Introduction: Purple glove syndrome is an atypical and adverse reaction to intravenous phenytoin, which is characterized by oedema, pain and a dark purple-bluish discolouration, typically located on an upper extremity. The clinical manifestation of this syndrome occurs in three stages: appearance, progression and resolution of symptoms. PGS develops up to 12 hours after administration of intravenous phenytoin and it disappears in a few weeks or months. Objective: The aim of this article is to summarize the current state of knowledge about purple glove syndrome: the pathophysiology, risk factors, the diagnosis and the current treatment. Brief descriptions of the state of knowledge: Despite many years PGS is still unexplained phenomenon. It is claimed that vascular tearing, micro-extravasation, alkaline pH of the solution or unidentified procoagulant mechanism can cause tissue impairment. The treatment depends on a limb elevation, physiotherapy, intravenous heparin administration, pain control, nitroglycerine application and a nerve blocks. To prevent PGS it is recommended to use oral phenytoin whenever possible, slow infusion rate of phenytoin less than 25mg/min, large cannula (20G or larger) in a large calibre vein and suitable, small doses. What is important fosphenytoin, a pro-drug of phenytoin, can also cause PGS, even though it was thought to be a safe drug, and a purple glove syndrome induced by fosphenytoin has never been described before. Summary: Despite the existence of many clinical trials, long term observations and scientific speculations, PGS can still be challenging for clinicians. There is a need for further scientific research to explain this phenomenon and to increase the awareness of this problem in general medical practice. Key words: PGS, purple glove syndrome, phenytoin |
