Imipramine First report of acrocyanosis in a * [i] child with enuresis: case report

Three weeks after beginning imipramine 25 mg/night for enuresis, an 11 -year-old girl developed sudden painful swelling of the medial 2 metacarpophalanged joints of her left hand and was admitted 7 weeks later. Physical examination revealed cold , blue and moist hands and feet and forearms showed livido reticularis . BP was 120/80mm Hg and pulse was 80/ min. Three days after discontinuing imipramine the patient had warm, pink and dry hands and feet and at 2 months follow-up hands and feet remained normal but enuresis persisted.

'There was neither clinical nor laboratory evidence of collagen vascular disease In this case_ There was, however, a strong temporal relation between Imipramine use and the occurrence of acrocyanos/s-' Acrocyanosis is an unusual adverse effect of imipramine and '_ , , has not been previously reported In children with enuresis',

Anderson RP, Morris BAP. Archives of Disease in

Childhood 63: 204·205, Feb 1988 "'"

6 REACTIONS" 26 March 1988 0157-7271 / 88/ 0326-0006/ 0$01 .00/ 0 © ADIS Press