Imipramine First report of acrocyanosis in a *[i) child: case report

After 3 weeks' therapy with imipramine 25mg at night for enuresis , an 11-year-old girl d eveloped painfu l swelling In her hands, which became increasingly blue and swollen. She was admitted 7 weeks later with both hands and feet appearing cold, blue and mOIst. Her only prevIous treatment had been a tonSillectomy and adenoidectomy 1 year previously Her father had maturity onset diabetes, her mother had been enuretlc until the age of 16 and her brother was also enuretic.

On admission BP was 120/ 80mm Hg, HR 80/ mln and all peripheral pulses were palpable. Clinical or laboratory eVidence of collagen vascular disease was absent. AcrocyanosIs was diagnosed Imipramine was Withdrawn as her enuresIs had failed to Improve. Three days later her hands and feet were warm and dry. At 2 months ' follow-up she reported only 1 episode of cyanosis: however, she has remained enuretic . Anderson RP Morns BAP Archives of Disease In Chi ldhood 63 204·205 Feb 1988 ",.

Manic disorders: incidence study Kupfer DJ Carpenler LL Frank E Possible role of anlldepressan1s In preclpl1allng mania and hypomania In recurrenl depression American Journal of Psychlalry 145 804 808 Jul 1988 ""

0156-2703/ 88/ 0806 -0009/ 0$01 .00/ 0 © ADIS Press INPHARMA " 6 Aug 1988 9