Renal infarction due to ergotamine.
Learning points for clinicians 

A 54-year-old Caucasian male non-smoker presented to the Emergency Department with severe left loin pain of sudden onset for the last 3 h. He reported frequent migraines for the last 20 years, for which he had been taking occasional ergotamine 1 mg/caffeine tablets, obtained over-the-counter overseas. The migraines had worsened recently, attributed to stress at work and therefore he had been taking the ergotamine almost daily. On the day prior to admission, he had taken three tablets over 24 h, and reported increasingly severe episodes of loin pain occurring about 1 h after administration of the second …