[Ergotism of therapeutic origin. A report of 4 new cases (author's transl)].

The observations concern ischemic accidents with various localizations (lower limbs, tongue, uterus, intestine, heart, liver) corresponding to 4 observations for which ergot derivatives (ergotamine tartrate) can be responsible. The most typical accidents are localized at the level of limbs and especially of lower limbs. In the greatest part of observations, a specific terrain (puerperium, vasomotor disorders, suspicion of temporal arteritis) can be considered and favouring factors (infection, and especially associated medicinal treatments with triacetyloleandomycin [2 observations] and Doxycyclin [1 observation]). The posologies of ergot alcaloïds were either superior to the limit prescription or normal. The duration of prescription was variable, but generally short. The arteriography confirms a vascular spasm. In an observation with very severe evolution, various ischemic localizations inducing amputation, two intestinal resections and an hemodialysis for lactic acidosis were noted. These ischemic accidents have to be noticed as early as possible in order to start a treatment; the best one seems to be the association of sodium nitroprussiate in intravenous perfusion with peri-dural anesthesia in an antalgic aim.