Coma blisters, peripheral neuropathy, and amitriptyline overdose

A brief report

Sheilagh Maguiness, Lyn Guenther, David Shum

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
Pages (from-to)438-441
Number of pages4
JournalJournal of Cutaneous Medicine and Surgery
Volume6
Issue number5
DOIs
StatePublished - Sep 1 2002

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Amitriptyline
Peripheral Nervous System Diseases
Blister
Coma
Intercellular Junctions
Tight Junctions
Benzodiazepines
Endothelial Cells

Cite this

Coma blisters, peripheral neuropathy, and amitriptyline overdose : A brief report. / Maguiness, Sheilagh; Guenther, Lyn; Shum, David.

In: Journal of Cutaneous Medicine and Surgery, Vol. 6, No. 5, 01.09.2002, p. 438-441.

Research output: Contribution to journalArticle

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