Effect of sildenafil citrate (Viagra) on erectile dysfunction in a patientwith familial amyloidotic polyneuropathy ATTR Val30Met

A 34-year-old male patient with familial amyloidotic polyneuropathy (FAP) a myloidogenic transthyretin (ATTR) Valine30Methionine (Val30Met), who underw ent a liver transplantation in Sweden in 1994, was treated with sildenafil citrate (Viagra) to ameliorate his erectile dysfunction (ED). Some clinical symptoms and the examination data for autonomic functions were improved af ter liver transplantation, but ED was never improved after the operation. F ive years after liver transplantation, he requested a sildenafil citrate th erapy to enhance his erectile potential. One and a half hours after the adm inistration of 25 mg of sildenafil citrate, the skin surface temperature ar ound the pelvic area increased and the penis became erect, though the postd ose hemodynamic parameters did not significantly change fi om the respectiv e baseline or predose values. He was able to have sexual intercourse, thoug h ejaculation did not occur. This case report appears to suggest that silde nafil citrate is an effective drug to treat ED in patients with an organic impairment of the autonomic nervous system without altering systemic circul ation. (C) 2000 Elsevier Science B.V. All rights reserved.