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

IntroductionNon-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 c...

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Bibliographic Details
Published in:	Journal of the Royal Army Medical Corps 2017-10, Vol.163 (5), p.361-363
Main Authors:	Ionescu, Anne-Marie, Hutchinson, Sarah, Ahmad, Mehtab, Imray, Christopher
Format:	Article
Language:	eng
Subjects:	Adult Analgesics Cold Cold Injury - complications Cold Injury - physiopathology Drug dosages Feet Foot Injuries - complications Foot Injuries - physiopathology Humans Iloprost - administration & dosage Iloprost - adverse effects Iloprost - therapeutic use Infusions, Intravenous Injuries Male Military Personnel Pain Pain - drug therapy Pain - etiology Patients United Kingdom Vasodilator Agents - administration & dosage Vasodilator Agents - adverse effects Vasodilator Agents - therapeutic use
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Summary:	IntroductionNon-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 reportAn 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.DiscussionThe 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.
ISSN:	0035-8665 2052-0468