Ischemic Skin Necrosis in Hepatorenal Syndrome Patient Secondary to Terlipressin.

Hepatorenal syndrome and variceal bleeding are two serious complications of chronic liver disease. Terlipressin is commonly used for reversal of these conditions. Besides its clinical advantages, it often causes serious ischemic complications. These complications are seen in patients at risk. Ischemic events, typically involve peripheries, but gastrointestinal mucosa, coronary arteries, trunk, and scrotum are also rarely involved. We observed extensive skin necrosis of right hand and forearm of a 50-year female patient treated with terlipressin for hepatorenal syndrome. Since this event was never noticed earlier in tertiary care hospitals of our province; to the best of authors' knowledge, this is the first case in medical literature from this part of the country.