Document Detail

Paradoxical Reaction of Raynaud Phenomenon Following theRepeated Administration of Iloprost in a Patient with DiffuseCutaneous Systemic Sclerosis (October).
MedLine Citation:
PMID:  23032649     Owner:  NLM     Status:  Publisher    
OBJECTIVE:To report a paradoxical reaction of Raynaud phenomenon following the repeated administration of iloprost in a patient with diffuse cutaneous systemic sclerosis with vascular involvement.CASE SUMMARY:In January 2006, a 40-year-old male was diagnosed with diffuse cutaneous systemic sclerosis with pulmonary, esophageal, cutaneous, and vascular involvement (Raynaud phenomenon, with digital ulcers on his hands). In December 2008, treatment with iloprost was started due to worsening disease. Nine cycles of iloprost were administered at a rate of 0.5-1 ng/kg/min (6 hours per day, for 5 days every 6-8 weeks); the patient tolerated this treatment well. However, on the fourth day of cycles 10 and 11, the patient developed paradoxical Raynaud phenomenon in the hand with perfusion when the infusion was increased to 1 ng/kg/min, requiring treatment to be stopped. Treatment was continued during cycles 12 and 13 at 0.5 ng/kg/min; the patient tolerated the treatment well, although paradoxical Raynaud phenomenon occurred when the rate of infusion was increased.DISCUSSION:Raynaud phenomenon is extremely common in patients with scleroderma, and often is severe. Iloprost has vasodilating, antiplatelet, cytoprotective, and immunomodulating properties, and has been found to be an efficacious alternative to nifedipine for the treatment of Raynaud phenomenon in patients with scleroderma. The Naranjo probability scale indicated that iloprost was the probable cause of the paradoxical Raynaud phenomenon in this patient.CONCLUSIONS:This case demonstrates a probable relationship between the rate of infusion of iloprost and the paradoxical reaction of Raynaud phenomenon.
Rebeca Iglesias Barreira; Belén Bardán García; Mónica Granero López; Iria Rodríguez Legazpi; Hortensia Álvarez Díaz; Isaura Rodríguez Penín
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-10-2
Journal Detail:
Title:  The Annals of pharmacotherapy     Volume:  -     ISSN:  1542-6270     ISO Abbreviation:  Ann Pharmacother     Publication Date:  2012 Oct 
Date Detail:
Created Date:  2012-10-3     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9203131     Medline TA:  Ann Pharmacother     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
< Ferrol Health District, Ferrol, Spain.
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