| Toe Necrosis after Terlipressin Administration in a Patient with Hepatorenal Syndrome and Pedal Artery Stenosis |
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Byeong Joo Jo |
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Division of Gastroenterology, Department of Internal Medicine, Semyeong Christianity Hospital, Pohang, Korea |
| 테를리프레신 유발 족지 괴사: 간신증후군 환자에서 족배동맥 협착과의 연관성 |
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조병주 |
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포항세명기독병원 소화기내과 |
Correspondence:
Byeong Joo Jo, Tel: +82-54-289-1946, Fax: +82-54-275-0003, Email: jam1124@naver.com
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Received: 12 July 2025 • Revised: 4 September 2025 • Accepted: 16 September 2025 |
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| Abstract |
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A 74-year-old woman with liver cirrhosis presented with hepatorenal syndrome and was treated with terlipressin and albumin. Despite a transient improvement in renal function, the patient developed bilateral toe cyanosis and necrosis during treatment. Computed tomography angiography revealed moderate and severe stenosis of the right and left dorsalis pedis arteries, respectively. Terlipressin was discontinued immediately, and surgical amputation was considered, but deferred because of poor cardiac and hepatic reserves. The patient received conservative wound care but eventually died of multi-organ failure. This case suggests that terlipressin-induced peripheral ischemia can be exacerbated in patients with pre-existing peripheral arterial stenosis or severe cardiac dysfunction. In such high-risk patients, careful evaluation of the vascular and cardiac status before therapy and close monitoring during treatment may help reduce the risk of this rare but serious complication. |
| Key Words:
Terlipressin; Gangrene; Peripheral arterial disease; Hepatorenal syndrome |
| 주제어:
테를리프레신; 족지 괴사; 족배동맥; 간신증후군 |
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