01536nas a2200205   4500000000100000008004100001260001200042653002800054653001600082653003900098653000900137100001100146700001400157700001400171700001400185245011500199490000700314520099500321022001401316       2024                            d  c09/202410aCardiovascular medicine10aDermatology10aGeneral practice / family medicine10aSkin1 aKaur M1 aBudania A1 aAgrawal A1 aLahoria U00aSevere postural hypotension and sinus bradycardia with thalidomide in patients with erythema nodosum leprosum.0 v173 a<p>Two men in their 60s and 40s were diagnosed with erythema nodosum leprosum based on the development of recurrent painful ulcers and nodules, respectively, for the previous 6 months. Thalidomide 100 mg four times a day, along with MB-MDT, was started in both patients. Both patients experienced severe dizziness on rising from a seated posture soon after initiation of thalidomide and a decrease in blood pressure and heart rate. Cardiovascular/neurology examination and routine blood investigations were normal. An autonomic nervous system assessment indicated bradycardia, postural hypotension and decreased cardiac autonomic function. The dosage of thalidomide was then gradually reduced over 4-5 days to 100 mg/day following a suspicion that thalidomide was the cause of postural hypotension. The dizziness subsided, and blood pressure and heart rate returned to normal.We concluded that thalidomide was the culprit behind bradycardia and dose- dependent postural hypotension.</p>  a1757-790X