Document Detail

Coma blisters, peripheral neuropathy, and amitriptyline overdose: a brief report.
MedLine Citation:
PMID:  12447625     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Coma blisters are most commonly associated with barbiturate and benzodiazepine overdose; however, they have also been described in association with many other substances, including amitriptyline. OBJECTIVE: To review the literature on the clinical manifestations of coma blisters in the setting of amitriptyline overdose. METHODS: Case report and literature review. RESULTS: Coma blisters in association with amitriptyline overdose have rarely been documented in the literature. Of the few reported cases, peripheral neuropathy has been present two (including our case report) out of four times. CONCLUSION: Amitriptyline is known to impair endothelial cell tight junction integrity. Thus, individuals with amitriptyline overdose may be predisposed to microvascular damage during the compression imposed from a comatose state. This may help to explain the tendency for patients to present with the interesting triad of coma, blisters, and neuropathy.
Sheilagh Maguiness; Lyn Guenther; David Shum
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Publication Detail:
Type:  Case Reports; Journal Article     Date:  2002-07-16
Journal Detail:
Title:  Journal of cutaneous medicine and surgery     Volume:  6     ISSN:  1203-4754     ISO Abbreviation:  J Cutan Med Surg     Publication Date:    2002 Sep-Oct
Date Detail:
Created Date:  2002-11-26     Completed Date:  2003-06-02     Revised Date:  2007-07-04    
Medline Journal Info:
Nlm Unique ID:  9614685     Medline TA:  J Cutan Med Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  438-41     Citation Subset:  IM    
University of Western Ontario, London, Ontario, Canada.
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MeSH Terms
Amitriptyline / poisoning*
Antidepressive Agents, Tricyclic / poisoning*
Blister / chemically induced*,  pathology
Coma / chemically induced*,  pathology
Peripheral Nervous System Diseases / chemically induced*
Reg. No./Substance:
0/Antidepressive Agents, Tricyclic; 50-48-6/Amitriptyline

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