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Neural Blockade, Urokinase and Prostaglandin E1 Combination Therapy for Acute Digital Ischemia of Progressive Systemic Sclerosis
Author(s) -
Shimizu Yoshiharu,
Mizutani Hitoshi,
Inachi Shin,
Tsuchibashi Tomoko,
Shimizu Masayuki
Publication year - 1994
Publication title -
the journal of dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.9
H-Index - 65
eISSN - 1346-8138
pISSN - 0385-2407
DOI - 10.1111/j.1346-8138.1994.tb03283.x
Subject(s) - urokinase , blockade , medicine , ischemia , progressive systemic sclerosis , prostaglandin , cardiology , disease , receptor
Abstract To treat severe painful digital ulcers on progressive systemic sclerosis (PSS) patients, we developed a new combination therapy which included neural blockade, intravenous urokinase, and prostaglandin E1 infusion. All of these are already recognized treatments for circulatory disturbances in PSS. Although each of them alone has a limited effect on the painful ischemic attack in PSS; in stepwise combination, neural blockade for release of vascular spasm and pain, prostaglandin E1 for further vasodilatation, and urokinase for thrombolysis were effective in the treatment of digital ischemia in two PSS patients. This therapy reduced the necrotic areas predicted before therapy and saved fingers from amputation. It also relieved the intolerable digital pain and effected the recovery of digital function.