Potential new treatment for non-freezing cold injury: is Iloprost the way forward?

Abstract

INTRODUCTION:

Non-freezing cold injury (NFCI) remains largely under-reported, and is of particular importance in the armed forces where its prevalence is greatest. Iloprost, a synthetic prostaglandin I2 analogue, has previously been used with some success in the treatment of vasospastic and freezing cold injuries, although its role in NFCI remains unclear.

CASE REPORT:

An Iloprost infusion was used to treat the long-term sequelae of an ex-soldier suffering with ongoing pedal pain and loss of function 20 years after the initial NFCI insult sustained on military exercise. Following 5 days of iloprost infusion, he reported 4 weeks of markedly reduced pain and increased mobility before symptom relapse. A second infusion was thus given 3 months later, which resulted in increased pain and analgesic requirements.

DISCUSSION:

The use of iloprost in the treatment of NFCI is discussed and its use in a condition which physicians consistently struggle to treat effectively is considered. Careful counselling is recommended as symptoms may be worsened.

• Authors: Anne-Marie Ionescu, Sarah Hutchinson, Mehtab Ahmad, Christopher Imray
• Journal: Journal of the Royal Army Medical Corps (J R Army Med Corps) Vol. 163 Issue 5 Pg. 361-363 (Oct 2017) ISSN: 0035-8665 [Print] England
• PMID: 28341787 (Publication Type: Case Reports, Journal Article)
• Copyright: Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Chemical References

• Vasodilator Agents
• Iloprost

Topics

• Adult
• Cold Injury (complications, physiopathology)
• Foot Injuries (complications, physiopathology)
• Humans
• Iloprost (administration & dosage, adverse effects, therapeutic use)
• Infusions, Intravenous
• Male
• Military Personnel
• Pain (drug therapy, etiology)
• United Kingdom
• Vasodilator Agents (administration & dosage, adverse effects, therapeutic use)