Purple Glove Syndrome

Purple glove syndrome (PGS) is a condition that occurs when medication or fluid leaks out of an intravenous (IV) line and into the surrounding tissue, causing edema, discoloration, and possible necrosis. PGS can lead to severe damage to the hand distal to the injection site and may even result in amputations. It is a rare but serious complication of IV therapy that can also cause low blood pressure, arrhythmias (especially QTc), and CNS/respiratory depression.From: A critical review of fosphenytoin sodium injection for the treatment of status epilepticus in adults and children [2022], Pocket Prescriber 2012 [2019]

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Published in Jonathan P Rogers, Cheryl CY Leung, Timothy RJ Nicholson, Pocket Prescriber Psychiatry, 2019

Jonathan P Rogers, Cheryl CY Leung, Timothy RJ Nicholson

SE (acute):dose dependent: drowsiness (also confusion/dizziness), cerebellar fx, rash (common cause of intolerance and rarely ⇒ SJS/TEN), N&V, diplopia, dyskinesia (esp orofacial). If iv, risk of ↓BP, arrhythmias* (esp ↑QTc), ‘purple glove syndrome’ (hand damage distal to injection site), CNS/respiratory depression.

A critical review of fosphenytoin sodium injection for the treatment of status epilepticus in adults and children

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Published in Expert Review of Neurotherapeutics, 2022

Jordan L. Clay, Nathan B. Fountain

Due to the alkalinity of the parenteral formulation of PHT, there is risk of local phlebitis and pain with injection [34–36]. If there is extravasation into surrounding tissue, there is risk of edema, discoloration, and possible necrosis, known as the ‘purple glove syndrome’ (PGS) which can lead to amputations. A recent review of all cases of PGS noted an incidence of 1–7%, with eight amputations reported [49]. These adverse effects also limit PHT’s ability to be administered via IM route. In contrast, IV and IM formulations of fPHT have been shown to have a significantly decreased incidence of soft tissue adverse effects when compared head-to-head with PHT in adults [27,37,38,46,49,50].

Purple Glove Syndrome

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A critical review of fosphenytoin sodium injection for the treatment of status epilepticus in adults and children