Strange New Case of “Holy Fire Disease” Reported

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Recently, a new report, which appears in the New England Journal of Medicine, looks at a woman who was diagnosed with an ancient disease known as the Holy Fire Disease. The health condition was popular during medieval times and is believed to be no longer existent.

The disease, also known as ‘St. Anthony’s fire’ has not been diagnosed in decades. The twenty-four years old affected woman had reportedly visited a hospital due to an extreme burning sensation in her legs.

The sensation started in the middle of her thighs and went all the way down to toes and had been going on for a time period of forty-eight hours.

During her examination, the doctors discovered that not only did the woman have burning and difficulty in moving legs or walking but also had discoloration. In addition, the legs were also cold to touch.

Both of these are usually the symptoms of a potential blood flow problem. Therefore, the doctors looked for her pulse and discovered that the woman did not have a pulse in dorsalis and popliteal pedis arteries.

These arteries are responsible for providing blood specifically to the lower parts of the legs. Computed tomography or a CT scan was then held to look for possible signs of damage in the arteries.

The CT scan report indicated that the blood flow had been hindered due to the narrowing of the arteries. In such conditions, doctors usually prescribe blood thinners to promote blood flow easily.

The woman was given heparin, which is a highly effective blood thinner, after which her legs got warmer and the burning sensation went away eventually. However, due to lack of blood flow, she developed gangrene in one of her toes, which had to be amputated.

The health condition is known as ‘ergotism’ today and is caused by the fungus known Claviceps purpurea. The fungus is fundamentally known for infecting staple cereals, such as rye and not for causing infections in humans.

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According to the new report on the woman’s case, she had developed Holy Fire Disease or ergotism due to drug interactions and not because of eating rye which was infected with Claviceps purpurea.

The disease is ancient and mentioned in various accounts of epidemics in mainland Europe from medieval ages. It was responsible for causing gangrene in a large number of people and even led to the development of issues including manic, seizures, and psychosis.

The condition generally referred to as ‘St. Anthony Fire disease’ dates back to 857 AD and is also associated with the ‘dancing plague’ of Europe which occurred between the fourteenth and seventeenth centuries.

Although the condition is much rarer in modern times, the drug Ergotamine is still used today for the treatment of issues including chronic headaches such as migraines. The drug alone is usually safe for usage.

However, in accordance with the authors of the report on the case, the woman developed Holy Fire Disease or ergotism due to taking the drug along with ritonavir for HIV, which inhibits the CYP3A4 enzyme in the body.

Inhibition of the enzyme led to a higher than normal ergotamine in the body, which then caused ergotism. After taking medication for two weeks and toe amputation, the woman was treated successfully.

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