BACKGROUND Sodium glucose cotransporter 2(SGLT2)inhibitors use has been associated with toe amputations and non-healing ulcers and gangrene mostly of lower extremities.There are no case reports about association of Em...BACKGROUND Sodium glucose cotransporter 2(SGLT2)inhibitors use has been associated with toe amputations and non-healing ulcers and gangrene mostly of lower extremities.There are no case reports about association of Empagliflozin with finger ulcers or gangrene.This is the first case report of Empagliflozin(Jardiance)an SGLT2 inhibitor causing gangrene of fingers and second case in literature about any SGLT2 inhibitor causing gangrene of upper extremity.CASE SUMMARY A 76-year-old man with type 2 diabetes mellitus sustained minimal trauma to both middle fingers,which started healing.He was started on empagliflozin a week later for management of type 2 diabetes mellitus and started developing gangrene to both middle finger tips along with neuropathic pain which worsened over the course of next four months.Investigations were negative for vascular insufficiency,infection and vasculitis and imaging of hand was normal.Discontinuation of empagliflozin slowed progression of gangrene and caused symptomatic improvement with reduction in neuropathic pain.CONCLUSION This case report suggests possible association of empagliflozin and finger gangrene and recommends that more research and awareness among clinicians is needed in this area.展开更多
Stem cell therapy (SCT) is a promising and prospective approach in the treatment of patients with severe peripheral arterial disorders, primarily with Buerger’s disease. However, very little is known about the durati...Stem cell therapy (SCT) is a promising and prospective approach in the treatment of patients with severe peripheral arterial disorders, primarily with Buerger’s disease. However, very little is known about the duration of the effect of SCT, and to our best knowledge no data are available on the efficacy and safety of repeated SCT in patients with Buerger’s disease. Here we report on two patients with severe Buerger’s disease, who received repeated autologous bone marrow-derived stem cell therapy. Our results show that a second SCT, applied to a previously treated leg 30 or 36 months after the first treatment was efficient in both cases. After twelve months, the clinical state of the repeatedly treated lower limb improved spectacularly and non-healing ulcers healed more rapidly than after the first SCT. No severe adverse events were detected. Thus repeated SCT offers a safe and efficient treatment option for relapsing patients at the advanced stage of Buerger’s disease.展开更多
文摘BACKGROUND Sodium glucose cotransporter 2(SGLT2)inhibitors use has been associated with toe amputations and non-healing ulcers and gangrene mostly of lower extremities.There are no case reports about association of Empagliflozin with finger ulcers or gangrene.This is the first case report of Empagliflozin(Jardiance)an SGLT2 inhibitor causing gangrene of fingers and second case in literature about any SGLT2 inhibitor causing gangrene of upper extremity.CASE SUMMARY A 76-year-old man with type 2 diabetes mellitus sustained minimal trauma to both middle fingers,which started healing.He was started on empagliflozin a week later for management of type 2 diabetes mellitus and started developing gangrene to both middle finger tips along with neuropathic pain which worsened over the course of next four months.Investigations were negative for vascular insufficiency,infection and vasculitis and imaging of hand was normal.Discontinuation of empagliflozin slowed progression of gangrene and caused symptomatic improvement with reduction in neuropathic pain.CONCLUSION This case report suggests possible association of empagliflozin and finger gangrene and recommends that more research and awareness among clinicians is needed in this area.
文摘Stem cell therapy (SCT) is a promising and prospective approach in the treatment of patients with severe peripheral arterial disorders, primarily with Buerger’s disease. However, very little is known about the duration of the effect of SCT, and to our best knowledge no data are available on the efficacy and safety of repeated SCT in patients with Buerger’s disease. Here we report on two patients with severe Buerger’s disease, who received repeated autologous bone marrow-derived stem cell therapy. Our results show that a second SCT, applied to a previously treated leg 30 or 36 months after the first treatment was efficient in both cases. After twelve months, the clinical state of the repeatedly treated lower limb improved spectacularly and non-healing ulcers healed more rapidly than after the first SCT. No severe adverse events were detected. Thus repeated SCT offers a safe and efficient treatment option for relapsing patients at the advanced stage of Buerger’s disease.
