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Journal of Education, Health and Sport

Purple glove syndrome
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Purple glove syndrome

Authors

  • Adrianna Szeliga Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń
  • Dominika Spyt Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń
  • Mateusz Kasinowicz Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń

Keywords

PGS, purple glove syndrome, phenytoin

Abstract

Introduction: Purple glove syndrome is an atypical and adverse reaction to intravenous phenytoin, which is characterized by oedema, pain and a dark purple-bluish discolouration, typically located on an upper extremity. The clinical manifestation of this syndrome occurs in three stages: appearance, progression and resolution of symptoms. PGS develops up to 12 hours after administration of intravenous phenytoin and it disappears in a few weeks or months. Objective: The aim of this article is to summarize the current state of knowledge about purple glove syndrome: the pathophysiology, risk factors, the diagnosis and the current treatment. Brief descriptions of the state of knowledge: Despite many years PGS is still unexplained phenomenon. It is claimed that vascular tearing, micro-extravasation, alkaline pH of the solution or unidentified procoagulant mechanism can cause tissue impairment. The treatment depends on a limb elevation, physiotherapy, intravenous heparin administration, pain control, nitroglycerine application and a nerve blocks. To prevent PGS it is recommended to use oral phenytoin whenever possible, slow infusion rate of phenytoin less than 25mg/min, large cannula (20G or larger) in a large calibre vein and suitable, small doses. What is important fosphenytoin, a pro-drug of phenytoin, can also cause PGS, even though it was thought to be a safe drug, and a purple glove syndrome induced by fosphenytoin has never been described before. Summary: Despite the existence of many clinical trials, long term observations and scientific speculations, PGS can still be challenging for clinicians. There is a need for further scientific research to explain this phenomenon and to increase the awareness of this problem in general medical practice.

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Published

2019-08-20

How to Cite

1.
SZELIGA, Adrianna, SPYT, Dominika and KASINOWICZ, Mateusz. Purple glove syndrome. Journal of Education, Health and Sport. Online. 20 August 2019. Vol. 9, no. 8, pp. 298-305. [Accessed 17 May 2025].
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Issue

Vol. 9 No. 8 (2019)

Section

Review Articles

License

The periodical offers access to content in the Open Access system under the Creative Commons Attribution-NonCommercial-ShareAlike 4.0

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